ATI OB Flashcards
Calendar Method is 14 days before the…
Days subtracted from shortest
Days subtracted from longest
14 days before the onset of the menstrual cycle
18 days from shortest
11 days from longest
Basal Body Temperature (BBT)
Temp drops slightly @ time of ovulation, check temp every morning
Sperm and Ovum viability (hrs)
Sperm = 120 hrs Ovum = 24 hrs
Symptom-Based Method (Cervical Mucus)
Post-ovulation, mucus is thin/flexible, can stretch between fingers (spinnbarkeit sign)
Diaphragm/Spermicide
Refit if…?
Leave in for how long…?
q2years or if 15lb/7kg weight change
6 hrs post coitus
Toxic Shock Syndrome
Associated w/…
3 S/S…
Diaphragms and Spermicides
high fever, watery diarrhea, HypoTN
Emergency Contraceptive time window
72 hrs
Transdermal Contraceptive Patch Use timing
same day q3weeks
Injectible Progestin (Depo-Povera)
How often
When start
2 S/S
q11-13weeks
1st 5 days of menstrual cycle
↑ thromboembolism ↓ bone density
Infant Plastibell
▲ diaper timing
Clean?
Tx for pain?
q4hrs
DON’T
Tylenol
Newborn Ranges
Serum Bili, BgL, Hct, WBC
↓ 8 mg/dL
40 - 60 mg/dL
48 - 69%
9k - 30k
Newborn Ranges
HR, Temp, Length, Weight
120 - 160/min
36.5º - 37.2º
45 - 55 cm/18 - 22 inch
2.5 - 4kg
Newborn feed times
Min, when, on what, how so?
15 - 20 minutes
On demand
Nipple + Areola
Tummy to tummy
Leopold Maneuver (4)
Fundus
Fetal back
Inlet
Attitude of Head
MSAFP Effective timing
When
Low = 2 Dx
High = 2 Dx
15 - 22 weeks
Low / Low Estriol / high hCG = Downs
High = NTD
Biophysical Profiling (BPP) assesses (5) and score total
FHR Breathing movements Gross body movements Fetal tone Qualitative Amniotic Fluid Volume 10/10, 2 points each
None Stress Test (NST) assesses (1) and when done
FHR
3rd trimester
Trimester timings (1st, 2nd, 3rd)
1st = 0 - 12 2nd = 13 - 24 3rd = 25 - 40
Nageles Rule
-3 months, +7 days, +1 year from conception
APGAR (5) and score total
HR, Resp effort, Muscle tone, Reflex, Color
10/10, 2 points each
Graffian Follice
Expels mature ovums
Carseats (3)
rear facing until 2 y/o
Turn airbag off
45º to prevent airway obstruction
S3, epistaxis/stuff nose, ↑ caloric intake. numbness in fingers
Common @ 2nd trimester
Traditional Spanish Practices for post-birth (4)
Warm milk
3 days bedrest
14 days until bathing
Protect head/feet from cold air
Expected weight gain range from pregnancy
25 - 35 lbs
Ultrasonography purpose in pregnancy
located placenta
Stages of Labor First (3), Second, Third, Fourth
First (latent 3cm, active 4cm, transition 8cm+), Second (birth), third (delivery of placenta), fourth (1 - 4 hrs until VS stabilization).
Cleaning Breath vs. Patterned Breathing
Cleaning = start to gain focus
Patterned Breathing = during transitional phase
Ferning Test
Amniotic fluid dries in a fern shape
Catecholamines what and fx
hormone r/t anxiety/fear r/in myometrial d/fx
Natural Active/Passive vs. Artificial Active/Passive
Active = exposure r/in antibody creation (exposure/vaccine) Passive = antibodies given (milk/gamma globule INJ)
Folic Acid counters
NTD and Tubal pregnancy
Presumptive S/S pregnancy (2)
S/S and Quickening
Quickening
Fluttering movements of fetus 16 - 20 weeks gestaiton
Probably S/S pregnancy (4)
Ab. enlargement, named signs, +Fetal pregnancy test/outline
Hegars Chadwicks Goodells Ballottement Brackton Hicks Contractions
softening/compressability lower uterus deepened violet-bluish cervix/vaginal mucosa softening of cervial tip rebound of engaged fetus false painless contractions
Positive S/S pregnancy (3)
Fetal ♥ Sounds
Radiography
Palpated Fetal movement
GTPAL
Gravidity Term births (↑ 38 weeks) Preterm births (↓ 20 - 37 weeks) Abortions/Miscarriages Living Children
BP, pulse, and RR ↑ r/t pregnancy
5 - 10 sys/dia
5 - 15/min
1 - 2/min
Percutaneous Umbilical Blood Sampling (PUBS)
detects fetal anomalies
FHR can be heard by Doppler as early as…
Ultrasound
Measurable fundal hieght
10 - 12 weeks
16 - 20 weeks
12 weeks
Rationale for following Prenatal tests
Blood type, Rh
CBC, HH
Hgb electrophoresis
Blood types of mom/baby
infection/anemia
hemoglobinopathies (sickle/thassalemia)
Group B Streptococcus (GBS) test timing
35 - 37 weeks
Rationale for following Prenatal Tests 1hr/3hr BgL Papanicolaou (PAP) (3) Vaginal/Cervical Culture (3) Venereal Disease Research Laboratory
hyperglycemia ( ↑ 140 mg/dL 1hr)
cervical cancer, herpes 2, human pap
Strep B, gonorrhea, chlamydia
Syphilis
Contraction Stress Test what (2) and assesses
brush nipple/give pitocin, fetal tolerance of contracitons
Alpha Fetoprotein is measured w/… and timing
Amniocentesis 16 - 18 weeks
High AFP and Low AFP = ???
NTD
Chromosomal disorders
Fetal Lung Test is done when…?
Ratio = maturity?
Absence of ____ = respiratory distress
37 weeks
2:1
Phosphatidylglercol (PG)
Causes of bleeding in…
1st trimester (2)
2nd trimester
3rd trimester (2)
spontaneous abortion, ectopic pregnancy
trophoblastic disease
placenta, abruptio previa
Ectopic pregnancy S/S (2)
unilateal lower-quadrant ab pain w/out bleeding
shoulder pain
Trophoblastic dz S/S (2)
AKA Hyatidid mole
N/V with scant/profuse dark brown/red vaginal bleeding
Placenta Previa vs. Abruptio previa S/S
they allow?
painless bleeding vs. bleeding w/ sharp abdominal pain/rigid uterus
Vaginal examinations
Abortions (cramps, bleeding, cervix status) Threatened Inevitable Incomplete Complete Missed Septic Recurrent
light, light, closed moderate, moderate, dilated severe, severe, dilated light, light, closed none, brown discharge, closed varies, malodorous discharge, dilated varies, varies, dilated
TORCH infections what and acronym meaning
cross the placenta and are teratogenic
TOxoplasmosis, Rubella, Cytomegalovirus, Herpes Simples virus
Medication for Gonorrhea/Chlamydia
S/S, Chlamydia r/in if untreated
Azithromycin (Zithromax)
white/yellowish green discharge
Pelvic Inflammatory Dz
Medication for Candida Albicans
Fluconazole (Diflucan)
S/S MagSulfate Toxicity (5)
Counter med.
Ø deep tendon reflex Urine output ↓ 30 ml/hr RR ↓ 12/min LoC Dysrhythmias
Calcium gluconate
Incompetent Cervix medications + tx (2)
tocolytics
bedrest and hydraiton
Hyperemisis Gravidarium medications (4), tx (2), R/F (3), ketones?
IV LR, Vit B, antiemetics, corticosteroids
Monitor I&Os and NPO 24 - 48 hrs
obesity, multifetal preg, migraine headaches
in Urine
Anemia medication
Iron Dextran (Imferon)
S/S Hypoglycemia (3) vs. Hyperglycemia
hunger, blurred vision, tingling
thirst, N/V, polyuria
Gestational HTN week, BP
Severe = BP w/ s/S
after 20th week
140/90 or higher 4 - 6 hrs apart
160/100 or greater w/ proteinuria, oliguria,
HELLP
Hemolysis
Elevated Liver enzymes (ALT/AST)
Low Platelets (↓ 100k)
Take ferrous sulfate with…?
VitC, juices.
Preterm labor what is and 2 medications
Contractions and cervical ▲ between 20 - 37 weeks
Nifedipine (Procardia/Adalat)
MagSulfate
Nifedipine (Procardia/Adalat) fx, effect, do not take w/…?
Ca Chnl blocker
Ø contractions
DO NOT TAKE WITH MAGSULFATE
MagSulfate Fx, watch for, counter w/
Tocolytic to relax suppress contractions
SoB, crackles, TSS
Calcium gluconate
Betamethasone (Celestone) #shots and fx
2 IM 24 hr apart to enhance fetal lung maturity
Premature rupture of membranes (PROM) what is and tx
Rupture 1 hr before labor within 20 - 37 weeks
▲ Preceding Labor (8)
BWLC
BEGR
backache weight loss (1 - 3 lbs) Lightening (easier breathing, ↑ pressure on bladder) Contractons Bloody show Energy burst GI changes Rupture of membranes
5 P’s of the labor process
Passenger Presentation Passageway Powers Position
Presentation Occiput Mentum Scapula Sacrum/Feet
Head
Chin
Shoulder
Breech
Lie
Transverse
Parallel/Longitudinal
Spine relationship to mother
Attitude
Flexion
Etension
chin/extremities flexed vs. not flexed
Large gush during birth? Priority is…?
Assess FHR for distress
Pain during Stages of Labor
1st - visceral back/leg
2nd - somatic
3rd - pelvic
4th - soreness
Drug timing during stages
1st - sedatives
2nd - opiods/epidural
2nd - spinal, pudendal, local infiltration
FHR Patterns Accels FHR brady FHR tachy Early Decels Late Decels Variable Decels Decrease/Loss FHR
Reassuring! Side lying, O2 mask Ø pitocin O2 mask, IV fluid Ok Side lying, O2 mask Ø pitocin Side lying, O2 mask Ø pitocin stimulate scalp
Perineal Lacerations
1st, 2nd, 3rd, 4th degree
skin
muscle
anal
anterior rectal wall
Contraction durations to discontinue Pitocin
↑ 90 seconds
Amnioinfusion is for…? (2)
Oligohydraminos and Fetal Cord Compression