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OB test 1 Flashcards

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1
Q

Oral contraceptives
instructions
disadvantages
contraindications

A

instructions: take at bedtime if nausea
take at the same time
miss one pill take asap
Miss more than 2 call dr. use back up

disadvantage: don’t protect against STI
Increase risk of stroke/HTN

contraindications: breast feeding
Older than 35
Smoking
Diabetes/cirrhosis

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2
Q

IUDS
2 types
advantage
disadvantage

A

T shaped device in uterus (chem. changes sperm)

2: hormone releasing (progesterone)
copper releasing

Advantage: long term/ very effective
can use when breastfeeding

disadvantage: No STI protection
Risk of PID

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3
Q

Preconception counseling

A

Evaluation of chronic conditions
Folic acid 400-800 mcg daily
lifestyle changes

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4
Q

Presumptive sings of pregnancy
(Mom thinks she may be pregnant but s/s can be related to other illness)

A

Amenorrhea/Fatigue
Breast changes
Urinary frequencies
Quickening
Uterine enlargement
N&V

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5
Q

Probable signs of pregnancy
(signs that the doctor can observe to prove you are pregnant)

A

+ pregnancy test
abd enlargement
Hegar sign
Chadwicks sign
Goodell sign
Ballottement sign
Braxton hicks

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5
Q

Positive signs of pregnancy
(can only be attributed to a baby)

A

Fetal heart sounds
visualization of fetus by ultrasound
Fetal movement

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5
Q

What is quickening?

A

slight fluttering movements of the fetus felt by the momma at approx. 16-20 weeks

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5
Q

What is hegar sign?

A

the softening and compressibility of the lower uterus

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6
Q

What is Chadwicks sign

A

deepened violet bluish color of the cervix and vaginal mucossa

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7
Q

What is Goodells sign?

A

softening of cervical tip

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8
Q

What is Ballotlement sign?

A

the rebound of the unengaged fetus

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9
Q

Explain Naegel’s rule.

A

Take the 1st day of the last menstrual cycle
Subtract 3 months
Add 7 days
Add a year

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10
Q

What does GTPAL mean

A

Gravidity
Term births
Preterm births
Abortions/miscarriages
Living children

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11
Q

Viability means?

A

The point at which a fetus can survive outside of the uterus

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12
Q

Chloasma is?

A

increased pigmentation on the pts face

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13
Q

Linea nigra is?

A

a dark pigmented line that forms from the umbilicus to the pubic

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14
Q

Striae gravidarum are also known as?

A

Stretch marks

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15
Q

Lab test done when you become pregnant

A

Blood type/ Rh factor
CBC with differential/Hgb/Hct
Rubella titer/Heb B/GBS/UA
Glucose test/PAP test
Vaginal/cervical culture
PPD/VDRL (vineral)/HIV/Infection

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16
Q

1st trimester :

A

Confirm pregnancy
Check for STI
Lifestyle changes
Common discomfort of pregnancy

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17
Q

2nd trimester:

A

Anatomy scan between 18-22 weeks
Glucose scan
Rhogan given

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18
Q

3rd timester:

A

GBS screen
Leopolds maneuver
Strep B test
Prepare for labor

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19
Q

How much weight should a pregnant woman gain?

A

25-35 lbs total

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20
Q

Gestational diabetes test
patho
risk factors
risk to mom
medication

Study These Flashcards
A

Placental hormones induce insulin

Macrosomia/hyperglycemia/hyperbillrubinemia

Polyhydramnios/preeclampsia/T2DM

Metformin/regular/lantus

21
Q

1st and third GTT readings

Study These Flashcards
A

1st > 140

3 hr 1st draw: >180+
2nd: > 155+
3rd: >140+

22
What is BPP?
Real time with ultrasound to visualize physical and physiological characteristics of fetus and its response to stimuli.
23
What is Amniocentesis? What does it look for?
Aspirate amniotic fluid Neural tube/chromosomal defects Administer RhoGan Monitor FHR
24
What is percutaneous umbilical blood sampling? What is it looking for?
Fiber optic scope inserted to collect blood from umbilical cord Kleihaver-Betke test CBC count with differential Indirect Coombs test (RH antibodies) Karyotyping (visualizing chromosomes) Blood gas
25
What is the Kleihaver-Betke test:
determines if the mother and babies blood have become mixed.
26
Chorionic villus sampling is what? Why?
Assess a portion of the placenta 1st timester alternative to amniocentesis Need a full bladder
27
Why is magnesium given? Therapeutic serum level S/E Antidote
Depress myometrium contractility Relax smooth muscle of uterus 4-7 Flushing/lethargy/HA/muscle weakness/dry mouth/ decrease reflexes Ca Gluconate 1 G IV
28
Bethametasone what is it ? nursing actions?
Enhances fetal lung maturity increases surfactant production in fetus 12 mg IM for 2 doses q 24 7 days prior to delivery Assess hyperglycemia/infant lung sounds
29
Iron teaching
Take on empty stomach with orange juice Diet rich in vit. C/fiber/fluids
30
RhoGram is what? When is it given?
Rh- mom with Rh + child Given 28 weeks/ postpartum
31
A molar pregnancy is;
abnormal trophoblastic growth
32
Preterm labor occurs when?
20-36 weeks with cervical changes
33
Gestational HTN is what?
Begins after 20 weeks Blood pressure 140/90 Returns to base line by 12 weeks postpartum
34
Preeclampsia is?
HTN/HA/Edema
35
Eclampsia is?
HTN/HA/Sz/Coma Severe epigastric pain Hyperreflexia
36
Risk factors for premature rupture of membranes
Shortening of cervix/ preterm labor 2-3 trimester bleeding Low BMI Copper/Vitamin C deficiencies Tobacco/substances use Pulmon./conn. tissue disorder
37
What is cervical cerclage?
stitches placed around the cervix to prevent preterm birth
38
A normal kick count is?
10 kicks in 2 hours
39
What is a normal newborn vital signs:
HR: 110-160 RR: 30-60 T: 97.7- 99.5 BP: 60-80/40-50
40
What is ectopic pregnancy? risk factors? expected findings? Labs
Fertilized ovum outside of the uterine cavity usually in the fallopian tube that results in a tubal rupture or hemorrhage STI/IUD/Tubal surger Unilater. stabbing pain in the lower abd quadrant referred shoulder pain Menses 1-2 weeks late Scant/dark red/ brown spotting 6-8 wks post normal menses Vaginal bleeding if it ruptures/hemorrhage/shock Hcg/CBC/Rh factor/progesteron level Liver/renal function
41
Placenta previa is what? risk factors? expected findings? nursing? Labs
Placenta implants in the lower segment of the uterus near or over the cervical os. Bleeding in the 3rd trimester Previous placenta previa/ uterine scarring Maternal age > 35 Multifetal gestation/multiple gestations smoking Painless bring red bleeding in 2-3 trimester Uterus relaxes/soft/nontender Fetus breech/oblique/transverse Reassure FHR Decrease urinary output Bleeding/leakage/contractions Fundal height don't do vaginal exams IV fluids/blood/meds 02/bedrest Hgb/Hct/CBC/Coagulant Blood type/Rh factor Kleihaver-Betke test Transabdominal/transvag. ultrasound
42
Abruptio placentae is what? risk factors? s/s diagnosis nursing Labs Diagnostics
Premature separation of a normally implanted placenta from the uterine wall occurs after after 20 weeks/ 3rd trimester Coag defect (DIC) Maternal HTN/abd trauma cocaine/nicotine use premature rupture of membraines multifetal pregnancy sudden intense abd pain with dark red bleeding firm tender uterus fetal distress/ absent fetal heart tones hypovolemic shock Palpate uterus/tenderness/tone Assess FHR/immed birth IV fluid/blood O2/v/s/FHR/I&O Hgb/Hct/coag type and cross kleihaver-betke test Ultrasound/BPP
43
Early decelerations causes interventions
Mirror moms contractions from head compression continue to monitor/no intervention
44
Late decelerations causes intervention
literally comes later after moms contraction uteroplacental inufficiency DC Oxytocin position changes Oxygen (NRB) Hydration (IV) Elevate legs to correct hypotension
45
Variable decelerations cause intervention
variable looks V shaped cord compression DC oxytocin amnioinfusion pos. change (side lying/knee to chest) breathing techniques/Oxygen
46
Fetal Lie
relation of spine of the fetus to the long axis of the spine of the mother
47
Longitudinal fetal lie type of birth involved
Fetus supine is perpendicular with the mothers spine cephalic or breech
48
Transverse/horizontal fetal lie
baby is laying across the stomach
49
Oblique fetal lie
fetus is lying at an angle to moms spine. head down is across the cervix os with the butt up at the mothers ribs
50
Fetal presentations:
1. Cephalic: head first 2. Breech Butt/feet/fists first presenting part of the sacrum 3. Shoulder Shoulder first presenting part is the scapula
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