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N431 OB Final > Birth Complications > Flashcards

Birth Complications Flashcards

1
Q

What are the risk factors for placental abruption (6)

A
  • Placental abruption in previous pregnancy not caused by abdominal trauma
  • Chronic HTN
  • HTN related problems during pregnancy like preeclampsia, HELLP syndrome, eclampsia
  • Fall/blow to abdomen
  • Smoking/cocaine use during pregnancy
  • Older than 40
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2
Q

What are the s/s of placental abruption (3)

A
  • Painful vaginal bleeding
  • Shock if severe
  • Board-like abdomen
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3
Q

What are the interventions for a placental abruption (4)

A
  • Evaluate with ultrasound
  • No vaginal exams to avoid inducing hemorrhage
  • If minimal bleeding, +FHR, near delivery = attempt NSVD
  • Most require a c-section
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4
Q

What is placenta previa

A

Placenta implants in lower uterine segment near/over cervical os

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5
Q

What is a total placenta previa

A

Covers entire internal os

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6
Q

What is a partial previa

A

Incomplete coverage of internal os

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7
Q

What is a marginal previa

A

Edge is 2-3 cm from os

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8
Q

What are the s/s of placenta previa (2)

A
  • Painless vaginal bleeding after 24 weeks
  • No abdominal tenderness
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9
Q

What are the interventions for placenta previa (4)

A
  • Evaluate with ultrasound
  • No vaginal exams to avoid hemorrhage
  • Most require a c-section
  • Monitor for hemorrhage
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10
Q

What are the complications of a placenta previa (5)

A
  • Hemorrhage
  • Malpresentation
  • Preterm birth
  • Fetal anoxia/death
  • Placenta accreta
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11
Q

What is a cord prolapse

A

Cord is below the presenting part of the fetus and is being compressed

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12
Q

What positions relieve pressure on the cord

A
  • Trendelenberg
  • SIMS
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13
Q

What are the risk factors for a cord prolapse (8)

A
  • Breech
  • Footling
  • Transverse
  • Unengaged presenting part
  • Polyhydramnios
  • Preterm/small fetus
  • SROM/amniotomy
  • Long cord
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14
Q

How is preeclampsia diagnosed

A
  • HTN past 20 weeks
  • BP >140/90
  • Proteinuria >300 mg
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15
Q

What must be present in preeclampsia if there is no proteinuria (5)

A
  • Thrombocytopenia
  • Renal insufficiency
  • Impaired liver function
  • Pulmonary edema
  • Cerebral/visual symptoms
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16
Q

What is the first line treatment for preeclampsia

A
  • Labetalol
  • Methyldopa
17
Q

What is the 2nd line treatment for preeclampsia

A

Nifedipine

18
Q

What is the emergency treatment for preeclampsia

A
  • Magnesium sulfate
  • Hydralazine
19
Q

What position improves blood flow to fetus, decrease BP, and promotes diuresis during preeclampsia

A

left lateral recumbent

20
Q

What are the s/s of severe preeclampsia(16)

A
  • Epigastric pain
  • Headache
  • Visual disturbances
  • SOB
  • Dyspnea
  • BP >160/110
  • Proteinuria >3 g
  • Hyperreflexia
  • Clonus
  • Oliguria
  • Thrombocytopenia
  • Impaired liver function
  • Systemic edema
  • Pulmonary edema
  • IUGR
  • Fetal distress
21
Q

What are the s/s of eclampsia (5)

A
  • Seizures
  • Respirations stop and then are long and deep after
  • Hypotension
  • Disorientation, amnesia, coma after
  • Hyperactive reflexes before seizure
22
Q

What is the antidote to magnesium sulfate

A

Calcium gluconate

23
Q

How is calcium gluconate administered

A

10ml of 10% solution or 1g IV over 3 minutes

24
Q

What are the side effects of magnesium sulfate (12)

A
  • Decreased deep tendon reflexes
  • Respiratory depression, sedation
  • Muscle weakness
  • Slurred speech
  • Decreased consciousness
  • Hypotension
  • Decreased urine output
  • Feeling of warmth
  • Flushing/burning at IV site
  • Nausea
  • Decreased cardiac function
  • Bradycardia
25
Q

What are the assessments for magnesium sulfate (6)

A
  • Respirations <12
  • Serum levels >7 mEq/L
  • Decreased LOC
  • Muscle weakness
  • Urine output <30 ml/hour
  • Decreased deep tendon reflexes
26
Q

How is magnesium sulfate given

A

IV 4-6 g

27
Q

What are the risk factors for gestational diabetes (4)

A
  • <25 years
  • Obesity
  • Family/personal history of diabetes
  • African American, Native American, Latina
28
Q

What is the normal glucose level during the 2 hour glucose tolerance test

A

<140

29
Q

What is the pre diabetes level during the 2 hour glucose tolerance test

A

140-199

30
Q

What is the diabetes level during the 2 hour glucose tolerance test

A

> 200

31
Q

What is the fasting glucose during the 3 hour glucose tolerance test

A

> 95

32
Q

What is the 1 hour glucose level

A

> 180

33
Q

What is the 2 hour glucose level

A

> 155

34
Q

What is the 3 hour glucose level

A

> 140

35
Q

What is the A1C goal during pregnancy

A

<6%

36
Q

What is the fasting goal during pregnancy

A

65-95

37
Q

What is the goal for 2 hours post meal

A

<120

N431 OB Final (5 decks)

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