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Maternal Ob Exam 2 > Deck 1 Exam 2 > Flashcards

Deck 1 Exam 2 Flashcards

1
Q

Cocaine effects on pregnancy

A

Spontaneous abortions, abruptio placentae, pre term bith and still birth

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2
Q

newborns exposed to cocaine exihbit

A

neuro behavior distrubances, marked irritability, exaggerated startle reflex, SIDS

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3
Q

Marijuana affects on baby

A

appear to have withdrawal symptoms, trembling, excessive crying

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4
Q

Heroin affects on baby

A

restlessness, high pitched cry, irritibilaty, behavior can last for 3 months or more

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5
Q

Methadone is used for

A

therapy for pregnant women on opiods(Heroin)
it does cross placenta but effects to fetus are not as harsh Given for women to not experience withdrawals during pregnancy and help to recover mom from addiction Often causes abnormal fetal presentation

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6
Q

Cold Turkey is considered

A

not advisable during pregnancy because it is a risk to the fetur

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7
Q

Babies with fetal alcohol syndrome characteristics are

A

small eye openings, smooth philtrum, thin upper lip, single crease in palm

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8
Q

Fetal Alcohol Syndrome affect

A

the ability to receive sufficient O2 and development of brain

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9
Q

What would you ask a pregnant mom who drinks alcohol

A

when do you drink? when was the last time? How much?

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10
Q

Ecstasy use in pregnancy

A

irritability, jitteryness, crying

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11
Q

Cardinal signs of diabetes in pregnant women

A

polyuria, polydipsia, polypghagia and weight loss
vaginal or urinary infections (often yeast)
weakness

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12
Q

poluria
polydipsia
polyphagia

A

frequent urine
excessive thirst
excessive hunger

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13
Q

There are 2 basic classifications in diabetes in pregnancy

A 
gestational diabetes  (pregnancy related)
pre existing diabetes
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14
Q

normal maternal plasma glucose between

A

60-120 mg/dl

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15
Q

Diabetes Pregnancy

A

Maternal glucose crosses the placenta but mom’s insulin does not

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16
Q

what produces insulin

A

Islets of Langerhan

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17
Q

Pathiophysiology of diabetes

A

*Insufficient amount of insulin Glucose cannot enter cell=energy depleted
*cellular starvation and uses fats and proteins for energy
*ketogenesis= metabolizationi of fat
*glyconegenesis= breakdown of amino acids(protein)
*break down of amino acids=protein & ketones in urine
*high blood glucose concentration pulls H20 from cell to bloodstream and causes cellular dehydration
(thirsty, voiding more) eventually this will spill into urine

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18
Q

Risk Factors for diabetes

A 
Obesity  BMI>25
Older than 25
previous birth with GDM
diabetes in close relative
high risk ethnic group
abnormal glucose tolerance level  h/o
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19
Q

When do they perform screenings

A

24-28 weeks GTT(glucose challenge test)

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20
Q

Procedure for the 1st screening

A

ingest 50 g glucose(orange soda) draw blood 1 hr later >140 mg/dl 3hr GTT

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21
Q

3 hr GTT procedure

A

ingest 150 g CHO 3 days before
NPO night before test fasting blood test
give 100 g glucose 1 hr testing >180 mg/dl
2 >155 mg/dl
3 >140 mg/dl

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22
Q

what is another test done for checking for diabetes

A

Hb A1C can indicate 4-8 wks prior levels

8.6 % poor control

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23
Q

Effects of Diabetes/ Increased risk for

A 
Spontaneous abortion
polyhydramnios
preterm labor
big baby
PIH
infection
ketoacidosis
c section
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24
Q

Risks for baby

A

Macrosomia (big baby)
delayed lung maturity( insulin inhibits surfactant in lungs)
polycythemia (excess of RBC)

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25
Q

Pre existing diabetes increased risk for

A

decreased blood flow, damage to nerves, damage to blood vessels therefore the placenta may not be getting blood flow and baby is “starving” IUGR
(small baby)

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26
Q

Managing GDM

A

diet, exercise glucose monitoring, fetal surveillance

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27
Q

Diet for GDM

A

3 neals plus 3 snacks

bedtime snack most important due to a drop in blood glucose in the early am

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28
Q

when is glucose monitoring done

A 
done at least 4 X a day
before breakfast  (60-100 mg/dl)
3 postprandial (after meals)
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29
Q

What can they administer to client

A

Glyburide- lowers blood glucose by enhancing insulin secretion but it does not cross placenta

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30
Q

S/S of Hypoglycemia

A 
tremors
sweating
pallor, cold and clammy
disorientation, irriitability
H/A
hunger
blurred vision
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31
Q

What can you do to treat hypoglycemia

A

give pb crackers, milk, apple then retest
you want to eat something with protein
can give oj sometimes and it helps

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32
Q

S/S of hyerglycemia

A 
fatigue
flushed hot skin
dry mouth  excessive thirst
frequent urination
rapid deep respirations
odor of breath   acetone   (classic)
drowsiness
H/A
depressed reflexes
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33
Q

If insulin is required during labor

A

Regular Insulin

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34
Q

Postpartum

A

breastfeeding encouraged

converts glucose to lactose

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35
Q

Pregnancy Anemia defined as

A

hgb < 11g/dl in 1st trimester
< 10.5 g/dl 2nd
< 11 g/dl 3rd

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36
Q

what can you give to help with absorbing iron

A

orange juice

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37
Q

3 Anemias

A

Iron Deficiency
Sickle Cell
Folic Acid

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38
Q

What is given if serum blood draw finds viral loads not acceptable in an HIV pregnant mom

A

ZDV zidovudine to mom

given to baby after delivery

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39
Q

What are the classifications of cardiac disease?

A

Class I asymptomatic
Class II symptoms with ordinary activity slightly compromised
Class III symptom w/ sitting in chair (ex)
Class IV symptomatice at rest (cardiac insuff and anginal pain)

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40
Q

Is cardiac disease the most common cause of maternal death overall

A

Yes but is only in about 1% of pregnancies

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41
Q

What is your best best to relieve pain in cardiac disease pregnancy when in labor

A

epidural

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42
Q

drug therapy used in cardiac mom

A 
heparin (blood)  lasix(diuretic) betal blockers(inderal)antiarrhythmics (quindine)  antibiotics (penicillin)  digoxin(strenghtens contraction but does cross placenta)
tocolytics but try not to use because the pulmonary edema that it can cause
beta blocker  (proprandol)
vasodilators  (hydralazine) if diastolic is over 110
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43
Q

Should you restrict or force fluids in a cardiac client

A

Restrict

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44
Q

What do you assess/interventions in cardiac

A

s/s, b/p, ap, lungs, wt gain, edema HOman’s sign, chest pain
dietary teaching- high protein, iron and folic acid
low sodium

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45
Q

what do you assess for post partum

A

wt. gain, chest pain , edema, SOB, crackles wheezes JVD

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46
Q

what are 2 greatest risks

A

maternal-cardiac decompensation and impaired fetal gas exchange

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47
Q

What trimester is there an increased risk for asthma

A

3rd trimester and after a c section in recovery period

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48
Q

Do not give what drug to an asthmatic with postpartum hemorrhage

A

HEMABATE

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49
Q

What clients are more than likely to seize and to abrupt 3x more

A

Epileptic patient

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50
Q

This condition in not unusual in the last trimester and post partum

A

Bells Palsy it is unilateral and will resolve on its own

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51
Q

What are the causes of some high risk pregnancies

A

social, demographic, medical and obstetric factors

85% of pregnancies are normal

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52
Q

What are nursing goals of hi risk

A

maintain maternal/fetal well being
provide emotional support
provide comprehensive patient teaching

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53
Q

If someone calls and reports bleeding what are the first questions you are going to ask

A

how much and how far along are you

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54
Q

what will you assess for

A

(B/P& P) (best indicator for blood loss is (P)

observe for shock, count and weigh pads, assess FHR

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55
Q

What will you do if bleeding is a problem

A 
IVF w/18 gauge
02 
( CBC) Hct  hgb
notify
type and crossmatch
Rhogam if mom is RH-
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56
Q

Spontaneous Abortion symptoms

what should pt do

A

vaginal bleeding, cramp, backache, cervix closed

bed rest, no intercourse, draw/lab to check and see if HCG is high

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57
Q

Inevitable(Intermittent) Abortion

A

moderate copious blood, cramp, cervical os dilates, ROM

cannot stop, D&C usually necessary

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58
Q

What is an increase for hemorrage and infection after an abortion

A

fragments of the placenta not removed

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59
Q

Incomplete (SPab)

A

pass clot and it could be baby
chief danger is bleeding
usually D&C may need a transfusion

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60
Q

Complete Abortion

A

all products expelled

guilt is a big complication

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61
Q

Missed abortion

A

fetus dies in utero, ultrasound
symptoms of pregnancy will leave (HCG will fall)
may wait two weeks to see if deliver on own

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62
Q

Recurrent Abortion

A

3 or more consecutive abortions

d/t incompentent cervix

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63
Q

What is a cerclage

A

stitch cervix together until delivery Shirodkars

“purse string suturing”

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64
Q

Nursing dx for abortion

A

fear, pain, grief, fluid volume deficit

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65
Q

Where are most ectopic pregnancies

A

95% in fallopian tubes(ampule)

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66
Q

What is one of the leading causes of material death from hemorrhage

A

Ectopic pregnancy

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67
Q

what are the s/s of ectopic pregnancy

A

amenorrhea, abd pain(intense) breast tender, sometimes even a + pregnancy test, spotting

pain is the most predominate sign

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68
Q

what is cullen’s sign

A

blue coloration of umbilicus which is bleeding into abdomen

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69
Q

What is the mgmt of ectopic pregnancy

A

observe for s/s shock
pregnancy test, ultrasound, tubalplasty, salpingectomy
blood transfuisoins and IV fluids

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70
Q

What do they give to client to speed along the abortion of the ectopic pregnancy

A

Methotrexate IM (folic acid antagonist)
2 nd injection day 4
3rd injection day 7

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71
Q

What is Gestational Trophoblastic Disease

A

GTD molar pregnancy

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72
Q

What is molar pregnancy

A

abnormal development of placenta( grapelike clusters)

proliferated tropho tissue

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73
Q

Grapelike clusters form where

A

maternal side of placenta

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74
Q

Complete Mole characteristics

A

no genetic material, embryo dies

choriocarcinoma

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75
Q

partial mole characteristics

A

normal ovum fertilized by 2 sperm

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76
Q

s/s of of GTD

A 
vag bleeding  (brownish(prune juice)
polyuria
hyperemesis gravidarum because of elevated HCG
anemia
PIH prior to 24 weeks
absent FHY
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77
Q

Management of GTD

A

suction of evacution, cerclage, D&C, follow up, baseline chest xray(checking for cancer in lungs)
must avoid pregnancy for 1 year because the cancer feeds off of hcg in trophoblastic tissue

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78
Q

S/S of incompetent cervix

A

passive and painless dialation of cervical os without labor.
history or cervical trauma - multigravida, abortion
cervical funneling

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79
Q

what can be done for an incompetent cervix

A

cervical cerclage

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80
Q

What is hyperemesis gravidarum

A

excessive vomiting

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81
Q

complications from hyperemesis graviduram

A 
dehydration and electrolyte imbalance
metabolic alkalosis
hypovolemia, hypotension, tachyacardia
HCT and Bun    high
K Na Cl   low
small baby
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82
Q

What are you going to assess for in hyperemesisi

A 
Fluid volume deficit
hydrate
monitor I & o
assess skin turgor
 daily weight
assess for edema
administer antiemetics
v/s every 4 hrs
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83
Q

What kinds of fluids would you give for hyperemesis

A 
IV of TPN
potassium, 
vit B
gradually introduce oral fluids and soft foods
can give  phenergran, zofran
Always provide mouth care
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84
Q

What are the classifications of PIH

A

gestational hypertension ^ BP after mid preg w/o protein

transient hypertension ^bp resolved by 12 weeks pp

preeclampsia after 20 weeks ^BP + protein +2

eclampsia preeclampsia + seizures

chronic hypertension before pregnanc
y
preeclampsia superimposed on chronic hypertension

85
Q

Greatest risk factors in having PIH

A

< 20 years or > 40 yrs
low socioeconomic status
h/o pre eclampsia
ob complications:mole pregnancy, multiple gestation, diabetes

86
Q

What are the normal levels for uric acid and creatine and BUN

A

Uric 3.5
Creatnine 0.8
BUN 12

87
Q

What are risks of PIH for mom

A

abruptio placenta, maternal mortality, seizures, acute renal failure, DIC

88
Q

What are the risks for baby

A

IUGR growth restricted
IUFD fetal demise
oligohydramnios(reduced fluids)
hypoxia and acidosis(fetal distress) (late decels)

89
Q

Patho for PIH

A

H/A, visual disturbances, spots, RUQ abdominal pain, ^ liver enzymes, decreased urine

90
Q

S/S of preeclampsia

A

hypertension 30/15 over
severe 160/110
proteinuria 0.3 greater
severe +2

91
Q

What is something you can do to check for worsening signs of PIH (CLONUS)

A

pullt toes back and if it taps
hyperreflexia with or without clonus
knee kick is usually hyper

92
Q

what can you administer to try and control seizures in PIH

A

magnesium sulfate IV but must be on secondary line
4-6 gms loading dose over 20 min
1-3 gms/hr mtce

93
Q

what is the antidote for magnesium sulfate

A

calcium gluconate

94
Q

you will see these if toxcicity occurs

A

decreased variables

95
Q

What is HELLP Syndrome

A

b/p may or may not elevate but proteinuria will be present w/epigastric pain
life threating variation of pre-eclampsia
(hemolysis, elevated liver enzymes, low platelets)

96
Q

what are the s/s of HELLP

A

pain in ruq, the lower chest or epigastric, liver tenderness, n/v and severe edema

97
Q

what is hemolysis

A

breakdown of RBCS

98
Q

what caused bilirubin levels to go up

A

hemolysis

99
Q

if a mom is Rh- what must you give

A

Rhogam 2nd child is the one that is at risk for problem

100
Q

What are some causes of sensitization

A

previous delivery of Rh+
ab, ectopic and mom did not receive Rhogam
cvs, amniocentesis, PUBS, maternal trauma
blood transfusions of Rh+ blood

101
Q

What tests are done to detect rh sensitization

A

Indirect Coombs- done on mom’s blood to see antibodies present
Are present all you can do is monitor baby for anemia
If NOT present give Rhogam at 28 weeks and then 72 after delivery

Direct Coombs done on baby blood

102
Q

What kind of titer is drawn for rh

A

delta optical density if . 1 :16 PUBS can be done

103
Q

If mom is Rh- and the indirect and direct are - and baby is Rh+ then

A

give Rhogam 300 mg

104
Q

Erythroblasits fetalis

A

Hydrops fetalis is marked fetal edema
congestive failure
marked jaundice

105
Q

What are some of the Rh Alloimmuinization fetal risks

A

anemia
hemolytic syndrome
erythroblastosis fetalis

106
Q

when would you give Rhogam

A

pregnant women with no antibody titer on hand
mother whose baby’s father is rh+ or unknown
28 gestation age
after abortion
72 hours postpartum
amniocentisis and placent previa
invasive procedures that cause bleeding

107
Q

ABo incompatibility

A

Mother has type O blood and infant has A, B, AB

first infant is oftern involved it cannot be prevented

108
Q

Abo incompatibility causes

A

jaundice(hyperbilirubinemia)

109
Q

what can you use to treat jaundice

A

phototherapy

bili blankets

110
Q

Effects of surgery

A

1st trimester increase abortions
do not like to do gall bladder surgery in 1st
2nd less risk

111
Q

what would you do for mom in a surgery

A

put a wedge under hip to stop vena cava syndrome

you must monitor FHR

112
Q

What is common cause of fetal and mom death

A

abruption after a trauma must monitor at least 4 hours after trauma

113
Q

TRAUMA stands for

A

T triage (assess maternal ABC)
R resuscitation (CPR given up higher on sternum)
A assessment for maternal injuries, FHR
U Ultrasound
M management/monitor
A activate transport

114
Q

What does Kleihauer Betke test rule out

A

fetal hemorrhage

115
Q

What are risks for abruptions

A

Trauma, PIH, Substance abuse (cocaine), hydramnios

116
Q

What is T in TORCH

what would you give for it?

A

T- toxoplasmosis cats goats milk, undercooked meat

can cause blindness, deaf , mentally challenged

+IGM more recent infection (active)
-IGM and showing +IGG infection in past(G means gone)

Give spiramycin

117
Q

What is the O in Torch

A

Other-
* cystitis(UTI) cause preterm labor and ROM
*pyelonephritis(kidney infection) antibiotics IV amoxicillins, cephlasoporins
* vaginal candidiasis (yeast infection)
miconazole

118
Q

What is the R in TORCH

A

Rubella german measles
1:8 greater immune
if you are not immune you cannot have the shote until after delivery(live virus vaccine)

+IGM recent active infection
treat moms symptoms

119
Q

What is the C in TORCH

A

cytomegalovirus (CMV) 5th disease(slapped cheek)
most frequent cause of viral infections

if mom has never had and acquired then during pregnancy can produce mental retardation, mocrcephaly, hydrocephaly, cerebral palsy or mental retardation

120
Q

What is the H in TORCH

A

Herpes
35-36 weeks give acyclovir
c section

121
Q

Group B Strep info

A

baby is at risk not mom
test 35-37 weeks
penicillin G be in system at least 4 hrs prior to delivery

122
Q

What fetal lie do we want to see

A

longitudinal

123
Q

what flexion do we want to see

A

vertex

124
Q

what fetal attitude do we want

A

normal flexion, cephalic with ROA or LOA

125
Q

what is considered a good strong contraction

A

60 mm of Mercury(HG)

126
Q

Primary force

Secondary force

A

strong contractions

using addt’l abd muscles

127
Q

what is frequency in contractions

A

beginning of 1 ot beginning of another (measured in minutes)

128
Q

what is duration

A

how long last beginnig of contraction to end (Measured in seconds)

129
Q

intensity

A

refers to the strength(rise in intrauterine pressure) measure by palpating but only true way is intrauterine cath (internal monitors)

130
Q

what occurs during resting tone between contractions

A

circulation 0-15 mm HG

131
Q

Causes for contractions

A

Pitocin
prostaglandins
progesterone when it goes down it makes contraction

132
Q

True indicator of labor

A

cervical dilation

133
Q

NST

A

reactive if there are 2 accels in 20 minutes

134
Q

False Labor

A

irregular contractions that do not increase induration and intensity

contractions lessened by walking

135
Q

CST

A

is positive if you see late decelerations

136
Q

What softens cervix and weakens Ripens

A

cervidil thin tissue inserted around cervix

cytotec pill

137
Q

True Labor

A

contractions at reg. intervals increase in duration and intensity
discomfort pain in back and radiates to front of abdomen
walking intensifies

138
Q

Latent Phase

A 
reg. mild conrtractions 
dilation  0-3 cm
frequency   10-30 min  5-7 min
duration    30-40 sec
25-40 mm HG

4-7 cm
2-3 min
40-60 sec
50-70 mm HG

8-10 cm
1.5-2 min
60-90 sec
70-90 mm HG

139
Q

Second Stage

A

pushing stage complete dilation
1.5-2 min
60-90 sec
70-100 mm Hg

140
Q

3rd stage

A

placenta delivery

infant born, uterus contracts, placenta begins to separate

141
Q

4th stage

A

1-4 hours
firm fundus decreases blood loss
tremors are normal

142
Q

Will not do epidural if platelets are less than

A

100,000 normal value 150,000
WBC can go up to 15,000-20000
HCT <32 (not good)

143
Q

What are the causes of pain in each stage

A

1st dilation of cervix
2nd increase from hypoxia, baby thru canal
3rd placenta expelled

144
Q

What is the main reason of FHR

A

to see how baby is responding to each contraction

145
Q

if you find heartbeat in upper quads

A

means BReech

146
Q

Normal FHR

A

110-160 bpm over 10 minutes between contractions

147
Q

Variability

A

fluctuation of FHR in 1 min
how the CNS is working
want moderate 6-25 bpm

absent no change no wiggles and jiggles
minimal 25 bpm caused by hypoxia

148
Q

what affects variability

A

baby sleeping
medicines
early gestation
acidosis ph down when 02 down

149
Q

What increases variability

A

need stimulation

150
Q

what can cause tachycarida

A

mom has infection for every degree of temp high baby increase 10 bpm

fetal hypoxia (baby compensates from 02 deficit by HR increase)
fetal infections
151
Q

causes of bradycardia

A

asphyxia
abruption, cord prolapse,
continuous head compression

152
Q

Accelerations

A

15bpm X 15 sec in 20 minutes 2 of them

153
Q

Early decelerations

A

caused by fetal head compression

return to baseline by end of contractions(mirror the contraction)

154
Q

Late decelerations

A

caused by UPI(uterine placenta insufficiency) b egin after contraction lines smoother
requires nursing interventions

155
Q

Variable decelerations

A

caused by cord compression
look different shap, duration, looks like U, W,V
require nursing interventions

156
Q

what are interventions for variable decels

A 
assess
if prolapsed cord then hold pressure on presenting part until someone can help
reposition mom
stop pitocin
admnisiter8-10 02 by mouth
increase IV fluids
continuous electronic monitoring
notify physician
prepare for immediate delivery if necessary
157
Q

breathing techniques what llevel is used regardless of what level

A

cleansing breath begins and ends each pattern

158
Q

1st pattern of breathing

A

slow, deep breathing (slow paced) chest up and out inhales through nose exhales thru lips

159
Q

2nd pattern of breathing

A

shallow or modified paced breathing

inhales and exhales thru mouth

160
Q

3rd pattern of breathing

A

pant blow paterned paced

forcefulexhalation thru lips

161
Q

Labor that happens so quickly within 3 hours

A

preciptous

162
Q

what is the goal of the epidural

A

to provide maximum pain relief w/minimum risk to mother and fetus

163
Q

Stadol

A

can sause n/v 1-2 mg IV

164
Q

Nubain

A

10 mg

165
Q

Demerol

A

25mg IV or 50 mg IV do not use unless preterm mom

166
Q

Sedatives

A

Seconal

167
Q

What is the antagonist for newborn

A

Narcan keeps on hand if baby doesnt want to respond “neonatal resusciation” 0.1 mg/kg given every 2-3 minutes IV or IM

can be given to mom for respiratory depression but be cautious if mom is on opiods

168
Q

what is in the test dose of the epidural

A

epinephrine if it placed correctly the heart rate should go up

169
Q

side effects of epidural

A

breakthrough pain, sedation, n/v pruritus, hyptoension

170
Q

Pre term labor

A

20-36 weeks

171
Q

baby not viable

A

before 24 weeks

172
Q

to stop premature labor what can dr give

A

tocolytics
magnesium sulfate,
brethine- mom feels like chest pains sq

173
Q

wht is given to help lung maturity

A

BETAMETHASONE(CELESTONE)

174
Q

given to mom corticosteriods

A

dexamethizone

175
Q

what are the 3 types of abruptio placentae

A

marginal blood escapes vaginally down cervix
central blood being trapped in middle
complete total separation massive bleed

176
Q

DIC

A

puts out fibrinogena nd then just stop BLEED OUT

177
Q

Abruption signs

A

blood loss- dark venous
severe or steady pain firm rigid abdomen(classic )
uterine may enlarge
FHT possibly absent

First assessment after finding hard rigid abd.
check baby
mom vs

178
Q

Sequel of prematurity

A

hypoxia, anemia, brain damage, fetal demise

179
Q

what would you do in case of abruptio

A 
2 lg bore ivs   blood products  iv fluids
monitor DIC
I&0
abd. girth
prepare for c section
neonatal resucitation equipment ready
180
Q

what is placenta previa

A

quiet sneaky
bright red blood
no pain

low lying placenta is over cerival OS

do not put anything in vagina

181
Q

what are clues to multiple gestation

A

visualization of 2 sacs at 5 to 6 weeks
fundal height greater than expected
ausculation of heart rates that differ at least 10 bpm

40-45 pd gain 24 pd by 24 week

182
Q

what does hydramnios effect and s/s

A

fetal malformation taht affect swallowing and neuro disorders

more than 2000 ml amniotic fluid
if you remove fluid to ffast before birth abruptio can happen

183
Q

oligohydramnios

A

less than 500 ml amniotici fluid

diagnosed when largest veritcal pocket is 5 cm or less

fetus is easily palpated and not ballotable

184
Q

what procedure is used in oligohydramnios

A

amnioinfusion (infusion of 100ml to 200ml/hr)

this can also be used in thick meconium problems

185
Q

what are some risks of preciptuous labor

A

trauma
laceration of cervix, vagina, perineum
post hemorrhage

fetal cerebral trauma from rapid descent
lose movement of shoulder(brachial plexus injury)
non reassuring fetal status

186
Q

S/s of infection in mom

A

eleveated Temp chills, foul smelling amniotic fluid, fetal tachycardia

187
Q

what can you give for precip labor and hyperstimulation of the uterus

A

postioning
pitocin
oxygen

188
Q

prolonged pregnancy

A

anything over 42 weeks

189
Q

what are the risks of Breech

A

increased risk for prolapsed cord
risk of cervical cord injuries
asphysia
birth trauma especially of the head

190
Q

what can cause macrosomia

A 
maternal obesity
diabetes
prior history of macrosomia
male ffetus
multiparity
prolonged gestation
hipsanic
erythroblastois fetalis
191
Q

what are the risks of macrosomia

A

cpd
prolonged labor
laceration of vaginal birth
hemorrhage

fetal
meconimu aspiration
asphysia
shoulder dystocia
fractured clavicle
hypoglycemia, polycythemia  hyperbilirubinemia
192
Q

implications of amniotic fluid embolism

A

respiratory distress suddenly, circulatory collapse, acute hemorrhage, dyspnea, cyanoisis, frothy sputum is a classic sign turn gray

193
Q

what is cephalopelvic disproportion (CPD)

A

fetus larger than pelvic diameters

194
Q

retained placenta may be a symptom of

A

accreta, chorionic villi attach to myometrium
increta myometrium invaded
percreta myometrium penetrated

after 30 minutes dr will manually remove

195
Q

amniotomy

A

artificial rupture of membrane AROM

196
Q

Pitocin

A

done in mu typically start at 2 and bump every 15-30 minutes

197
Q

funic presentation

A

umbilical cord is interposed between cervix and the presenting part

198
Q

episiotomy 2 types

A

midline

mediolateral

199
Q

vacuum assisted birth

A

suction cup if two tries and cannot get then go to surgery

200
Q

what is hydrops fetalis

A

esophagus doesnt form in 1 piece

201
Q

prolonged pressure to fetal head can cause in hypertonic labor

A

caput succedaneum, cephalhematoma, excessive molding

202
Q

what can you do to speed up someone in hypotonic labor

A 
nipple stimulation
oxytocin infusion
amnioty
encourage voiding
minimize vaginal exams
203
Q

what is POP

A 
persisitent occiput posterior  (baby is face up)
inadequate pushing
have back labor
can have lacerations
big baby
204
Q

what are some interventions you can do for POP

A

pelvic rocking

lunge from one side to another

205
Q

Brow presentation

A

face right at you
increase mortallity
non reassurring FHR

206
Q

what are some things you do for macrosomia

A

supra pubic pressure fist together right above pubic bone

mcroberts maneuver
knees to chest

207
Q

what is the procedure to get ready for csection

A

start iv D5Lr bolus of fluid antibiotic, epidural abd. prep foley cath bicitra, reglan, pepsid

208
Q

what kind of incision do you want for c section

A

transverse

insicion on the ithmus of the uterus

Maternal Ob Exam 2 (1 decks)

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