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OB/Peds > exam 1 > Flashcards

exam 1 Flashcards

1
Q

Four goals when providing care for infertility

A

Provide couple with accurate information
Assist in identifying cause
Provide emotional support
Guide and educate about treatment options

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2
Q

What classifies someone as infertile

A

If under 35 and have unsuccessfully been trying for 1 year
If over 35 and unsuccessfully been trying for 6 months

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3
Q

What can increase chance of infertility

A

obesity and hypothyroidism

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4
Q

Semen analysis

A

Gold standard test for men
Assess ability of sperm to move around and number of sperm ejaculated

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5
Q

Hormone analysis for men

A

Must abstain from sex for 2-3 days prior

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6
Q

Clomiphene/Clomid

A

Increase release of the egg
Increase chance of multiple fetuses
When taken with Metformin increases effectiveness

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7
Q

In vitro fertilization- embryo transfer

A

Woman’s eggs collected from ovaries, fertilized in lab and transferred to uterus

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8
Q

Gamete intrafallopian transfer (GIFT)

A

Oocytes retrieved from ovary, placed in catheter with washed sperm and transferred to end of uterine tube.
Fertilization occurs in uterine tube.

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9
Q

Therapeutic donor insemination (TDI)

A

Donor sperm used for inseminate female

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10
Q

Intracytoplasmic sperm injection

A

One sperm cell is injected directly into egg used with IVF

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11
Q

Cryopreservation of human embryos

A

Can freeze embryos and still be viable many years later

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12
Q

Contraception

A

Intentional prevention of pregnancy
May still be at risk for pregnancy

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13
Q

Peak fertility days

A

days 8-19
1 week before and 24 hours after ovulation

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14
Q

Coitus interruptus

A

withdrawal/pullout method

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15
Q

Fertility awareness methods (FAMs)

A

rely on avoidance of intercourse during fertile periods

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16
Q

Calendar method

A

11 days from longest cycle
18 days from shortest cycle
longest is 34 days - 11 = 23
shortest is 28 days - 18 = 10
need to be careful during days 10-23

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17
Q

Cervical mucus ovulation detection method

A

Cervical mucus will change
Prior to ovulation discharge is egg white and stretchy, then becomes watery, followed by thicker mucus that would accompany a pregnancy

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18
Q

Breastfeeding and contraception

A

inhibits estrogen levels and prevents ovulation, causes dry vaginal canal
Should prevent pregnancy for at least 6 months

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19
Q

Diaphragm

A

Barrier method
reusable.
Clean after each use.
Check for proper fit after pregnancy or weight changes

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20
Q

Cervical cap

A

Barrier method
More of a one size fits all diaphragm

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21
Q

Contraceptive sponge

A

Barrier method
Can be left in 24 hours but longer increase risk for toxic shock syndrome

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22
Q

Condoms

A

Petroleum jelly can cause condom to break

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23
Q

Hormonal methods

A

increase risk for cerebrovascular and vascular issues
Increase risk of DVT (increase when over 35 and smokers)

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24
Q

Progestin-only contraceptives

A

mini pill, injectables, implantable- Nexplinon)
Used for postpartum
Shot good for 3 months

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25
Q

Emergency contraceptives

A

Used within 72 hours
Plan B most readily available- increase progesterone- blocks ovulation
Copper IUD- need in provider office within 100 hours of intercourse

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25
Q

Emergency contraceptives

A

Used within 72 hours
Plan B most readily available- increase progesterone- blocks ovulation
Copper IUD- need in provider office within 100 hours of intercourse

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26
Q

IUDs

A

Small T shaped device inserted into uterus
Mirena loaded with pregestational agent
Copper is only nonhormonal IUD

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27
Q

Common complications with abortion

A

infection
retained products of conception
excessive vaginal bleeding

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28
Q

Gravidity

A

of pregnancies

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29
Q

Gravida

A

Woman who is pregnant

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30
Q

Nulligravida

A

Woman who has never been pregnant

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31
Q

Primigravida

A

Woman pregnant for the first time

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32
Q

Multigravida

A

Woman who has had 2 or more prgnancies

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33
Q

Parity

A

of pregnancies that reached 20 weeks

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34
Q

Nullipara

A

Woman who has not completed a pregnancy that reached 20 weeks

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35
Q

Primipara

A

Woman who has had 1 pregnancy reach 20 weeks

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36
Q

Multipara

A

Woman who has had 2 or more pregnancies reach 20 weeks

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37
Q

Preterm

A

20 weeks to 36 weeks 6 days

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38
Q

Early preterm

A

20 weeks to 33 weeks 6 days

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39
Q

Late preterm

A

34 weeks to 36 weeks 6 days

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40
Q

Early term

A

37 weeks to 38 weeks 6 days

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41
Q

Full term

A

39 weeks to 40 weeks 6 days

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42
Q

Late term

A

41 weeks to 41 weeks 6 days

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43
Q

Post term

A

42 weeks and beyond

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44
Q

Viability

A

Capacity to live outside uterus
22 weeks to 25 weeks

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45
Q

Two digit summarizing obstetric hx

A

GP
gravida para

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46
Q

Five digit summarizing obstetric hx

A

GTPAL
Gravidity, term, preterm, abortion, living children

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47
Q

hCG

A

Earliest biochemical marker of pregnancy
Can be detected as early as 7 to 8 days after ovulation

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48
Q

ELISA

A

Basis for most OTC home pregnancy test
Medication use, hormone-based tumors, or improper collection cause inaccurate results

49
Q

Signs of pregnancy

A

Presumptive- changes felt by the woman
Probable- changes observed by examiner
Positive- attributed only by presence of fetus (heart tones, US, movement)

50
Q

Factors affecting labor

A

Five P’s
Passenger (fetus and placenta
Passageway (birth canal)
Powers (contractions)
Position of mother
Psychologic response

51
Q

Elements about passenger that affect birth

A

Size of fetal head
Fetal presentation
Fetal lie
Fetal attitude
Fetal position

52
Q

Molding

A

bones shift to fit through birth canal

53
Q

Fontanels

A

Soft spots
Triangle- anterior
Circle- posterior
Bulging fontanels could indicate increase intracranial pressure

54
Q

Vertex or cephalic

A

Head down

55
Q

Breech

A

Head up

56
Q

Transverse

A

side to side

57
Q

Occipitoanterior

A

Fetus has neck flexed and the occiput of head is facing anterior aspect of pelvis
Also called OA, can be right or left

58
Q

Occipitoposterior

A

Fetus neck extended and occiput is facing posterior pelvis.
Also called OP or sunny side up
Takes longer to deliver and cause more back pain

59
Q

Frank breech

A

Sacrum presenting and legs are straight up by head

60
Q

Complete breech

A

Sacrum and feet presenting

61
Q

Single footling breech

A

1 leg is extended down

62
Q

Vertex presentation

A

Chin all the way to chest
Presents smallest part of head
Most ideal

63
Q

Sinciput presentation

A

Chin tucked some
Military position

64
Q

Brow presentation

A

Neck flexed
Delays labor and delivery is more difficult

65
Q

Fully engaged or zero station

A

baby head positioned at ischial spine

66
Q

Start actively pushing at what station

A

+1 or +2

67
Q

Station of crowning

A

+5

68
Q

Gyneocoid pelvis

A

most desired
More traditional size pelvis

69
Q

Cephalopelvis disproportion

A

Pelvis is too small for larger size of head

70
Q

Powers

A

Primary powers (uterus contractions)
Secondary powers (maternal efforts- can be affected by epidural, fatigue, and lack of glucose)

71
Q

Position of laboring woman

A

Widen the pelvis and relax muscles
If baby in OP place mom on hands and knees in hope to turn the baby

72
Q

Effacement

A

Thinning of cervix
Fingertip length is no thinning
0-100%

73
Q

Dilation

A

0-10
10 can not feel any cervix

74
Q

Labor

A

Process of moving fetus, placenta and membranes out of uterus and through birth canal

75
Q

Signs preceding labor

A

lightening or dropping
bloody show
braxton hicks
mucus plug
nesting
diarrhea
water break- true sign of labor

76
Q

Stages of labor

A

1st stage- onset of contractions to full dilation
2nd stage- full dilation to birth
3rd stage- birth of fetus to delivery of placenta
4th stage- 2 hours post delivery of placenta (recovery)

77
Q

7 cardinal movements of labor

A

engagement
descent
flexion
internal rotation
extension
restitution (external rotation)
expulsion (birth)

78
Q

Normal fetal HR

A

110-160

79
Q

Nursing care focus during labor and birth

A

assessment
support
best possible outcome
Role is mostly assessment

80
Q

First stage of labor

A

Begins with onset of regular uterine contractions
Ends with full effacement and dilation

81
Q

Three stages of the first stage of labor

A

Latent phase
Active phase
Transition phase

82
Q

Latent phase
first stage of labor

A

Up to 3 cm
Longest phase
Cervix is thinning and dilating
Mothers alter/happy/anxious

83
Q

Active phase
first stage of labor

A

4 to 7 cm
Stronger and closer contractions
Mothers can only answer questions between contractions

84
Q

Transition phase
first stage of labor

A

8 to 10 cm
Hardest spot of labor
Contractions are strongest and longest
Mothers less interactive

85
Q

True labor

A

Must have cervical change, rupture of membranes, stronger and closer contractions, back contractions

86
Q

False labor

A

Contractions irregular and do not get stronger or closer together, braxton hicks, 1 sided contractions

87
Q

EMTALA

A

Emergency medical treatment and active labor act
Ensures women receive emergency treatment or labor care
Must check every woman who comes in to make sure they are not in labor

88
Q

Prenatal data
assessment

A

Due dates
Blood type
Any titers they have done
Anatomy scan
Low or high risk pregnancy

89
Q

Admission data
assessment

A

Update all questions and info
Ensure all info is correct
# of pregnancies

90
Q

Psychosocial factors
assessment

A

Exposure to smoking
Use of drugs
Abuse hx

91
Q

Labor plan
assessment

A

Epidural
Support team
How they react to pain
Comfort measure preference

92
Q

Cultural factors
assessment

A

Any ritual or practices
Need for translator

93
Q

Physical exam
assessment

A

Head to tie
Fetal heart tones (should be below belly button)
VS (closely watch BP)
Leopold maneuver (find fetal position)
Vaginal exam (cervix, discharge, leaking fluids)

94
Q

Contraction duration

A

How long takes to reach peak then go back to normal

95
Q

Frequency of contraction

A

Start of one contraction to start of another

96
Q

Amniotic fluid

A

Should be clear and odorless
Yellow- infection
Green- baby had BM in womb

97
Q

Second stage of labor

A

Infant is born
Begins with full dilation and effacement
Ends with baby’s birth
Usually 3 hours for first time moms and 2 hours for second time moms

98
Q

Two phases of second stage of labor

A

Latent phase- laboring down. allowing contractions to move baby down birth canal
Descent phase- Active pushing and urge to bear down. baby’s head is molding

99
Q

Supplies needed for second stage of labor

A

2 clamps
suction bulb
scissors
blanket
placenta bucket
sterile gloves
towels
gauze
gown

100
Q

Crowning

A

largest part of head is through

101
Q

Episiotomy

A

purposeful cuts to allow extra room
1st degree- through first layer of skin
2nd degree- extend through muscle of peritoneum
3rd degree- extend through anal sphincter
4th degree- extend through rectal mucous. Rectum exposed to vagina

102
Q

Third stage of labor

A

Baby has been born, waiting on placenta
Umbilical cord will change color
Once placenta releases will be gush of blood, pt then gibes small push

103
Q

Fourth stage of labor

A

VS and fundal massage every 15 minutes for first 2 hours
VS and assessment on baby every 30 minutes
Skin to skin!!!

104
Q

Trimesters

A

First- week 1 through 13
Second- week 14 through 26
Third- week 27 through 40

105
Q

Nagele rule

A

Determine first day of LMP subtract 3 months add 7 days plus 1 year
Alternatively add 7 days to LMP and count forward 9 months

106
Q

Maternal adaptations of pregnancy

A

Accepting the pregnancy
Identifying with mother role
Reordering personal relationships
Establishing relationship with fetus
Preparing for childbirth

107
Q

Paternal adaptations of pregnancy

A

Accepting the pregnancy
Identifying with father role
Reordering personal relationship
Establishing relationship with fetus
Preparing for childbirth

108
Q

Barriers to obtaining prenatal care

A

Lack of motivation to seek care
Inadequate finances
Lack of transportation
Inconvenient clinical hours
Problems with child care

109
Q

Initial Prenatal visit

A

Reason for seeking care
Current pregnancy
Obstetric and gynecologic hx
Health hx
Nutrition hx
drug use and herbal preparations
Family hx
Mental health screening
Intimate partner violence
Physical exam
Lab test

110
Q

Follow-up prenatal visits

A

Physical exam
Fetal assessment- fundal height, fetal heart tones, gestational age, health status
Clean catch urine
Group B strep test between 35 and 37 weeks

111
Q

Components of early pregnancy classes

A

Early fetal growth and development
Physiologic and emotional changes of pregnancy
Human sexuality
Nutritional needs
Environmental and workplace hazards

112
Q

Components of late pregnancy classes

A

Management of discomfort in labor
Relaxation
Breathing techniques
Imagery and visualization
IV meds and epidurals

113
Q

Nutrient needs before conception

A

Healthful diet before conception ensures adequate nutrients are available for developing fetus
Folate or folic acid intake is important

114
Q

Factors that contribute to increase in nutrient need during pregnancy

A

Development of uterine-placental-fetal unit
Increase maternal blood volume and constituents
Maternal mammary development
Increased metabolic rate

115
Q

Nutrition issues during pregnancy

A

Alcohol
Caffeine
Artificial sweeteners
PICA
Food cravings

116
Q

Adolescent pregnancy needs
Nurses work to-

A

Improve nutritional health by focusing on knowledge and planning of meals
Promote access to prenatal care
Develop nutrition interventions and educational programs effective with adolescents
Understand factors that create barriers to change in adolescent population

117
Q

Preeclampsia

A

Cause still unknown
Speculation that poor intake of specific nutrients may be contributing factor
Adequate diet best means of prevention

118
Q

Physical activity during pregnancy

A

Moderate exercise improves muscle tone, shortening course of labor

Liberal amounts of fluid before, during and after
Sufficient calorie intake for pregnancy and exercise

119
Q

Nutrient needs during lactation

A

Similar to during pregnancy
Calorie intake increase of 330 kcal
Increase maternal weight loss during lactation
Smoking, alcohol, and excessive caffeine should be avoided

120
Q

Nutrition care and teaching

A

Components of adequate diet
Individualizing diet related to needs, culture, finances
Coping with nutritional-related discomforts
Use nutrition supplements appropriately
Consult or refer to other professional

OB/Peds (1 decks)

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