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OB > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

What is true labor?

A

cervical changes with rhythmic contractions

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2
Q

When should the 1st prenantal visit occur?

A

within 12 weeks

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3
Q

What labs are taken at 1st prenatal visit?

A

HGC
CBC
Type & Rh
RPR
HIV
Hemoglobin
Electrophoresis
(check anemias),
A1C
UA
cervical
exam
pap
smear,

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4
Q

How often should prental visits be between 12-28 weeks?

A

Once a month

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5
Q

What labs are taken at the monthly visits 12-28 weeks?

A
  • UA at every visit
  • TB skin test,
    Rubella titer, Hep
    B test, Triple
    Screen & MSAFP
  • Ultrasound
  • 1hr glucola (24-28
    weeks)
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6
Q

How often should prenatal visits be between 29-36 weeks?

A

Every 2 weeks

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7
Q

What labs are drawn every 2 week at 29-36 weeks?

A
  • UA at every visit
  • Ultrasound if not
    done before
  • Type & Rh
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8
Q

How often should prenatal visits be from 36 weeks-delivery?

A

weekly

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9
Q

What labs will be drawn from 36 weeks-delivery?

A
  • GBS, HIV
  • Possible U/S for
    presentation
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10
Q

What are warning signs during first trimester of pregnancy that the doctor may follow-up on?

A

-severe vomiting

-chills, fever

-dysuria

-diarrhea

-abdominal cramping

-vaginal bleeding

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11
Q

How does the menstrual cycle correlate with getting pregnant or not?

A

A woman is most fertile during the ovulation period (12-14 days before next cycle) of the menstrual cycle, and is the time where a woman is most likely to get pregnant

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12
Q

What are examples of barrier method contraceptives?

A

spermicides, condoms, diaphragms, cervical caps, contraceptive sponge

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13
Q

When should a female obstain from intercourse using cervical mucus method?

A

when cervical mucus is wet, clear, and stretchable

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14
Q

What is education concerning barrier method contraception?

A

use in conjunction with spermicidal foam to increase effectiveness, recommended to prevent STDs

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15
Q

What is an important education about spermicidal method?

A

not effective when a
highly reliable contraceptive method is sought

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16
Q

What are important things to note about diaphragm method?

A
  • Round flexible device that covers the cervix
  • Must be fitted for size by health care provider
  • Inserted into the vagina up to 6 hours before
    intercourse
  • Used with spermicidal jelly or cream
  • Must remain in place for 6-8 hours after
    intercourse
  • Increases risk of urinary tract infections
  • Return to health care provider for size
    refitting if weight fluctuates up or down
  • Does not prevent STD
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17
Q

What is the teaching when a birth control pill is missed and its been <12 hours?

A

Take 1 pill immediately and
take the rest of the pack at the
usual time
No backup method needed
No Emergency
Contraceptive needed

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18
Q

What is the teaching when a birth control pill is missed and its been over 12 hours?

A

Take pill as soon as
remembered and continue the
rest of the pack at the usual
time
Use EC if had unprotected
intercourse in the past 7
days
Use condoms or abstinence
for the next 7 days

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19
Q

What are serious side effects for oral contraceptives?

A
  • A = abdominal pain
  • C = chest pain or shortness of breath
  • H = severe headache
  • E = Eye problems such as vision loss, dizziness
    or blurring of vision
  • S = Severe leg pain or swelling
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20
Q

What is the education needed for transdermal contraception patch?

A
  • Contains a combination of estrogen and
    progestin
  • Patch placed on abdomen, buttocks, upper
    outer arm or torso BUT NOT THE BREAST
  • Replaced each week for 3 weeks
  • Not used for 1 week to allow for
    menstruation
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21
Q

What is the education needed for vaginal ring?

A
  • Small flexible ring inserted deep into the
    vagina for 3 out of every 4 weeks
  • A new ring is used for each 4-week cycle
  • Delivers continuous levels of progestin &
    ethinyl estradiol
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22
Q

What is the education needed for depo-provera?

A
  • Given every 11-13 weeks
  • Suppresses ovulation and produces thick cervical mucus that decreases sperm motility
  • Effective, convenient, inexpensive compared to other methods
  • Menstrual bleeding is diminished or absent
  • May be a delay in fertility for up to 18 months when discontinued
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23
Q

What are side effects of IUD?

A

Side Effects: include irregular
menstrual cycles and increased bleeding
and cramping during menstruation

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24
Q

What are serious side effects of an IUD?

A
  • P = Period late abnormal spotting or bleeding
  • A = Abdominal pain; pain during intercourse
  • I = Infection exposure; STD’s
  • N = Not feeling well; fever and chills
  • S = String missing; shorter or longer
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25
Q

When is a IUD contraindicated?

A
  • Not recommended for women who have not
    had children
  • Not recommended for women with history of
    Pelvic Inflammatory Disease (PID)
  • If pregnancy occurs with IUD in place,
    increased risk for miscarriage and premature
    labor
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26
Q

What is the process of fertilization and implantation?

A

During fertilization, the sperm and egg unite in one of the fallopian tubes to form a zygote. Then the zygote travels down the fallopian tube, where it becomes a morula (3 days). Once it reaches the uterus, the morula becomes a blastocyst (4 days). The blastocyst then burrows into the uterine lining — a process called implantation. (6 days)

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27
Q

What is the structure of the placenta?

A

-Flat, disk shaped
-Structure composed of 15 to 20 lobes called cotyledons

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28
Q

What is the function of the placenta?

A

o Provides nutrients (O2) and removes waste (CO2)o Metabolizes drugs and other substances

o Produces hormones estrogen/progesterone for maintenance of pregnancy

§ Estrogen stimulates uterine development to provide environment for baby

§ Progesterone relaxes uterine muscle to prevent spontaneous abortion

o When Human Chorionic Gonadotropin is released it produces the placenta and begins to grow. An increase in HCG levels =indication of pregnancy

o Corpus luteum main source of estrogen and progesterone until month 3. After that the placenta is in charge.

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29
Q

What is the structure of the umbilical chord?

A

-Structure that connects the developing baby to the placenta
-Contains two arteries and one vein in utero

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30
Q

What is the function of the umbilical chord?

A

o Transport O2 and nutrients from Mom to baby and waste back to maternal blood
o Permits free movement for baby within the membranes
o arteries carry deoxygenated blood while veins carry oxygenated blood (when cord is cut those will close and switch functions)

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31
Q

What kind of blood do the arteries carry?

A

deoxygenated blood

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32
Q

What kind of blood do the veins carry?

A

oxygenated

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33
Q

What are the three fetal valves called in fetal circulation?

A

ductus arteriosis, foramen ovale, and ductus venosus

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34
Q

What is ductus arteriosis?

A

Valve that
shunts blood
around the
lung. (Just
enough to
keep lungs
viable)

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35
Q

What is foramen ovale?

A

Valve
allowing
blood to flow
directly from
right to left
atrium

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36
Q

What is ductus venosus?

A

Valve that
shunts
around the
liver

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37
Q

When does hematopoesis begin?

A

week 6

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38
Q

Why is it important to know about RBCs forming early in gestation?

A

It’s important to know if you have any RBC antibodies early in your pregnancy to help your baby avoid problems like anemia or jaundice.

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39
Q

What are presumptive signs of pregnancy?

A

breast changes, amennorrhea, N/V, urinary frequency, fatigue, quickening

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40
Q

What are probable signs of pregnancy?

A

Goodell sign, chadwick sign, hegar sign, positive pregnancy test, braxton hicks contractions, ballottment

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41
Q

What are positive signs of pregnancy?

A

Visualization of fetus by real-time ultrasound, fetal movements palpated, fetal movements visible,fetal heart tones detected by fetal stethoscope, FHTs detected by ultrasound, visualization of fetus by radiographic study

42
Q

What are expected findings of pregnant woman?

A

-increase in estrogen and progesterone levels
-uterus changes in size, shape, and position
-increase uterine blood flow and stronger muscles for birth process
-vaginal secretions increase
-expansion of vascular volume 45-50%
-cardiac output increase 25-50%
-clotting factors increased
-oxygen consumption increased 15-20%
-breathing changes from thoracic to diaphragmatic
-basal metabolic rate increases 10-20%
-linea nigra
-striae gravidarum
-chloasma
-palmar erythema

43
Q

When is hyperemesis gravidarum seen?

A

can start at 2 weeks and lasts until 20 weeks (first trimester)

44
Q

What is hyperemesis gravidarum?

A

Abnormal condition of pregnancy characterized by vomiting excessive enough to cause weight loss( > 5%), electrolyte imbalance, nutritional deficiencies, and ketonuria, and dehydration. Moms don’t eat because they’re throwing up: nutritional deficiencies.

45
Q

What is education for clients about IPV?

A

 Abuse is a violation of rights
 Facilitation of access to protective
and legal services is first step
 Support and community resources.

46
Q

What is a normal total weight gain during pregnancy?

A

25-35 lbs

47
Q

What is a normal weight gain during 1st trimester?

A

2-4 lbs

48
Q

What is a normal weight gain during 2nd and 3rd trimester?

A

1 lb/week

49
Q

What is folic acid used for in pregnancy?

A

help meet demands of increased blood supply and fetus

50
Q

What are items that would be considered PICA?

A
  1. Clay, soil
  2. Laundry starch
  3. Cornstarch
  4. Ice
  5. Freezer frost
  6. Baking powder
  7. Raw rice
  8. flour
51
Q

What are maternal characteristics that may cause a high risk pregnancy diagnosis?

A

-Biophysical-genetic considerations, nutritional status, medical and obstetric disorders
-Psychosocial-smoking, caffeine, alcohol, drugs, psychological status
-Sociodemographic-low income, lack of prenatal care, age, adolescents, mature mothers, parity, marital status, social determinants of health, ethnicity
-Environmental-infections, radiation, chemicals such as mercury and lead, therapeutic drugs, illicit drugs, industrial pollutants, cigarette smoke, stress, and diet.

52
Q

What are warning signs second/third trimester?

A

-persistent, severe vomiting
-sudden discharge of fluid from vagina <37 wks
-vaginal bleeding, severe abdominal pain
-severe backache/flank pain
-change in fetal movements
-contractions; pressure; cramping <37 weeks
-visual disturbances: blurring/double vision/spots
-face/fingers/sacrum swelling
-headaches; severe/frequent or continuous
-muscular irritability or convulsions
-epigastric/abd pain (heartburn/severe stomach ache)
-glycosuria, +GTT reaction

53
Q

When does advanced maternal age for pregnancy start?

A

35

54
Q

What are the maternal and fetal effects from toxoplasmosis?

A

o Maternal effects

§ Influenza- like aching

§ Lymphadenopathy

§ Spontaneous abortion

o Fetal effects

§ Congenital toxoplasmosis, LBW, hepatosplenomegaly c, jaundice and anemia

55
Q

What are maternal and fetal effects from “other” (AIDS, GBS)?

A

o Aids maternal effects
§ Antepartum – An increased incidence of other STD’s. Offered the option of ZDV.
§ Intrapartum – External EFM preferred. Avoid use of fetal scalp electrodes or blood sampling.
§ Postpartum – breastfeeding contraindicated. Universal precautions
o Aids fetal effects
§ If the mother is HIV+ the newborn is given an ELISA test for presence of HIV antibodies. If positive but asymptomatic at birth, s/s usually become evident during 1st year of life. FTT, liver and spleen involvement,bacterial
o GBS maternal effects
§ none
o GBS fetal effects
§ Sepsis, pneumonia or meningitis within 7 days of birth. Meningitis is the most common clinical symptom. Early (1st week of life, or late onset). May have permanent neurologic deficits

56
Q

What are materal and fetus effects from rubella?

A

o Maternal effects

§ Rash, fever, malaise

§ Spontaneous ab during 1st trimester or pregnancy

o Fetal effects

§ Deafness, MR, IUGR, cardiac defects and microcephaly

57
Q

What are maternal and fetal effects from Cytomegalovirus?

A

o Maternal effects

§ Flu-like symptoms; cervical discharge

o Fetal effects

§ Fetal or neonatal death; severe generalized disease c hemolytic anemia, jaundice, hydrocephaly or microcephaly

58
Q

What are maternal and fetal effects of hep b?

A

o Maternal effects

§ Fever, rash, arthralgia, abdominal pain, liver enlarged and tender

o Fetal effects

§ Prematurity; LBW

§ Development of acute infection at birth and perhaps neonatal death

59
Q

When is syphilis tested and how?

A

Screened at first prenatal
visit VDRL or RPR
serology and again in 3rd
trimester and at time of
birth if they are high risk.

60
Q

What are effects of syphillis on fetus?

A

 Pregnancy: May result in
spontaneous abortion or PTL.
 Transmitted across
placenta after approximately
18 weeks gestation.
 Newborn: Congenital anomalies
and/or congenital syphilis
 Congenital syphilis. (Test on
cord blood).

61
Q

What does the hypothalamus secrete?

A

gonadotropin releasing hormone

62
Q

What does the anterior pituitary secrete?

A

follicle-stimulating hormone

63
Q

What does the posterior pituitary secrete?

A

lutenizing hormone

64
Q

what does the follicular phase do to the follicle?

A

changes the primary follice to the graafian follicle, which stimulates ovulation (egg formation)

65
Q

What does the luteal phase do

A

turns the egg into the corpus luteum and degeneratin corpus luteum

66
Q

What does the graafian follicle produce?

A

grows and releases steady amounts of estrogen

67
Q

What does the corpus luteum produce?

A

progesterone

68
Q

What are the phases of the menstrual cycle?

A

menstruation, proliferative phase, ovulation, secretory phase, ischemic phase, back to menstruation

69
Q

How long is the follicular phase?

A

cycle days 1-13

70
Q

How long is ovulation?

A

cycle day 14

71
Q

How long is the luteal phase?

A

cycle day 15-28

72
Q

What is the role of GnRH?

A

stimulates the pituitary release of FSH and LH when hormone levels are low

73
Q

What is the role of FSH?

A

stimulates development of Graafian follicles and production of estrogen

74
Q

What is the role of LH?

A

trigger explosion of ovum from Graafian follicle and the formation of corpus luteum

75
Q

What is the role of estrogen?

A

stimulates thickening of the endometrium prior to ovulation an after menstration

76
Q

What is the role of progesterone?

A

prepares endometrium for a fertilized ovum should it occur

77
Q

What is the role of prostaglandins?

A

fatty acid classified as a hormone that affect ovulation, smooth muscle contractility, fertility, menstruation, and hormone activity.

78
Q

What is Hegar’s sign?

A

Softening and thinning of lower
segment of uterus – about the 6th week

79
Q

What is lightening?

A

fundal height decreases as fetus
descends into the pelvis in preparation for delivery (38
– 40 weeks)

80
Q

What is bellotement?

A

passive movement of fetus

81
Q

What is quickening?

A

Maternal observation of fetal movement
 18-20 weeks gestation (nulliparous) or 14-16 weeks
(multiparous).

82
Q

What is Chadwick’s sign?

A

bluish color of cervix

83
Q

What is Goodell sign?

A

Softening of cervical tip in a
normal unscarred cervix

84
Q

What BP is a danger sign in pregnancy?

A

140/90

85
Q

When are pregnant clients screened for gestational diabetes?

A

24-28 weeks

86
Q

What are cardinal signs of Preeclampsia?

A

PROTEINURIA
EDEMA
ELEVATED BP
HEADACHES OR DIZZINESS
BLURRED VISION
people eat every hot balloon

87
Q

What is the structure of amniotic fluid?

A

derives from maternal fluid by diffusion
Volume serves as indicator of fetal well-being

88
Q

What is the normal volume for amniotic fluid?

A

700-1000mL-term)

89
Q

What are the functions of amniotic fluid?

A

-maintain body temp
-barrier to infection
-allows lung development
-freedom of movement
-MS development
-cushion to outside forces
-symmetrical growth
-source for oral fluids and repository for waste

90
Q

What happens at 3 weeks of fetal development?

A

Heart starts beating & blood circulates

91
Q

What happens at 4 weeks of development?

A

■ 2- chamber forms a 4- chamber heart
■ Respiratory system begins

92
Q

What happens at 5 weeks of development?

A

Umbilical cord developed

93
Q

What happens at 8 weeks of development?

A

Gender distinguishable

94
Q

What happens at 12 weeks of development?

A

■ Placenta complete
-organ system complete
■ Thumb sucking
■ Fetus urinates in amniotic fluid-11

95
Q

What happens at 16 weeks of development?

A

meconium in bowel

96
Q

What happens at 20 weeks of development?

A

Quickening (Mom feels movement)
■ Lanugo covers the body

97
Q

What happens at 24 weeks of development?

A

vernix caseosa is thick
lecithin present

98
Q

What happens at 32 weeks of development?

A

L/S ratio 1.2:1 (lung maturity 2:1)

99
Q

What happens at 36 weeks of development?

A

lanugo disappears
L/S ratio >2:1

100
Q

What are major characteristics of viability?

A

CNS function and O2 capability of the lungs. weight of 500g, 20 weeks past conception (22 since LMP)

101
Q

What happens at 34 weeks of development?

A

lungs fully mature

OB (6 decks)

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