Exam 1 Flashcards

Question

Naegeles rule

Answer 1

Add 9 months and 7days to LMP

Answer 2

HIV Hepatitis B Drug testing

Answer 3

0-28 wks- monthly 29-36 wks- every 2 wks 37-40wks- weekly

Answer 4

Distance from pubic symphysis to highest part of uterus Fundal ht=wks gestation

Answer 5

15-18wks: multiple marker (birth defects) 15-26wks: amniocentesis (tests and diagnoses certain birth defects and genetic conditions) 24-28wks: GTT and coombs test (screen antibodies for Rh factor)

Answer 6

Vaginal bleeding Abd/epigastric pain Severe headache No fetal movement for more than 12hrs Temp>100.4 Any fluid from vagina (not leukorea)

Answer 7

Anemia Preterm birth Preeclampsia

Answer 8

Vaginal bleeding, preeclampsia, multiple gestation, gestational diabetes, preterm labor, dysfunctional labor, c-section Fetal complications: low birth wt, macrosomia, cogenital malformations

Answer 9

HR increases by 10-20 BP decreases slightly Bld volume increases by 40-45% Cardiac output increases 30-50% Thrombosis risk Palpitations

Answer 10

RR increases slightly Dyspnea Congestion that can cause nosebleed Change in voice SOB common in 3rd trimester

Answer 11

Should: TDAP, recombinant Hep B, inactivated flu vaccine Shouldn’t: measles/rubella, varicella, mumps, and live flu vaccines

Answer 12

No food cravings

Answer 13

Darkening of face

Answer 14

Spider veins

Answer 15

Phase 1: I am pregnant Phase 2: I’m having a baby Phase 3: I’m going to be a mom

Answer 16

Red, raised nodule on gums (bleeds easily)- enlarged as pregnancy progresses

Answer 17

14 days before next period Mature ovum lives 12-24 hrs than start to degenerate Sperm lives up to 5 days

Answer 18

Makes placenta raise BS

Answer 19

Maintains corpus luteum until placenta develops I’m urine/serum 10-14 days after conception

Answer 20

Increases blood flow to uterus softens cervix Initiate uterine activity maintain labor develops breasts secretion of prolactin

Answer 21

Prepare uterus for implantation Prevent immunologic response to fetus Supports until placenta develops Develops duct Al system for location

Answer 22

Relaxes pelvic muscles and joints

Answer 23

Promethazine

Answer 24

18wks gestation

Answer 25

Outer sac next to uterine wall

Answer 26

Inner sac next to fetus

Answer 27

Placenta fused to uterine wall Difficult separating at delivery

Answer 28

Low lying placenta covering uterus opening

Answer 29

Premature separation of placenta from blood clot Oxygen and nutrients to fetus are compromised Bed rest for mom as long as possible until delivery absolutely necessary

Answer 30

HcG Progesterone Estrogen HpL

Answer 31

20-umbilicus 36-xyphoid

Answer 32

98% water, 2% salt 34wks- 800 mL Term- 600mL

Answer 33

Increase discharge and acidity

Answer 34

Empty bladder before If cyst- ovarian function stops Measures cervical thickness

Answer 35

Heartburn Delayed gallbladder emptying N/V Constipation Hemorrhoids Hiatal hernia Increased vascularity of gums and saliva

Answer 36

Bladder displacement and enlarges Increased GFR, urinary stasis, frequency UTI risk Decreased bladder tone, BUN, Crt, uric acid, glucose clearance Specific gravity stable Protein in urine is BAD

Answer 37

May escalate during pregnancy 1st incidence during pregnancy

Answer 38

Sweat more, body odor and acne No douching Side sleep after 1st trimester

Answer 39

Safe up to 36 wks Ambulate every 1-2hrs to prevent thrombosis

Answer 40

Improve muscle tone Shorten course of labor Increase sense of well being

Answer 41

RBC ^20-30% Hct ^33-46% Hgb 10.5-11

Answer 42

Increased RLS Increased HR Palpitations Tachypnea Coolness to hands and feet

Answer 43

Take on empty stomach Vit C increases absorption Ca and tannic acid stop absorption

Answer 44

Red meats Poultry Legumes Green leafy veggies Dried fruits

Answer 45

Anticonvulsants Oral contraceptives Sulfa abts Alcohol

Answer 46

Dark green leafy veggies Black eyed peas Fortified cereals Rice Pasta Asparagus Brussels sprouts

Answer 47

Tocolytic Helps hold off preterm labor Relaxes uterus so contractions don’t occur

Answer 48

Terbutaline

Answer 49

Tremors Nervousness Pulm edema Arrhythmias HTN MI N/V High BS

Answer 50

Calcium channel blocker/tocolytic Suppresses labor

Answer 51

Orthostatic hypotension

Answer 52

Resolves eclampsia

Answer 53

Arrhythmias Bradycardia Flushing Diarrhea Hypothermia Muscle weakness Drowsiness Low RR

Answer 54

Steroid Given before delivery to prevent respiratory distress syndrome in newborns- beefs up their lungs

Answer 55

Uterotonic For induction of labor Control of postpartum bleeding

Answer 56

Abruptio placenta Coma/seizures Fetal- intracranial hemorrhage, hypoxia, asphyxia

Answer 57

For postpartum hemorrhage Contraindicated in HTN pts

Answer 58

Prostaglandin Ripens cervix for initiation of labor

Answer 59

Cx abnormalities Warm feeling in vagina Back pain Fever Urinary retention

Answer 60

Prostaglandin Cervical ripening and labor induction

Answer 61

Abd pain Diarrhea/ constipation Miscarriage Menstrual disorders Headache

Answer 62

Can cause birth defects Abortion Premature birth Uterine rupture

Answer 63

Prostaglandin For postpartum hemorrhage

Answer 64

Diagnosed before 20wks High risk for preeclampsia Risks: placental abruption, preterm birth, growth restriction

Answer 65

Decreases placental perfusion causing systemic disorder

Answer 66

Fam hx Multiples African American Obesity Before 19 and after 40 yrs old

Answer 67

BP >140/90 Protein +1 in urine Sudden wt gain Headache Swelling in hands and feet Increased DTR

Answer 68

BP >160/110 Protein +3 in urine Severe headache Blurred vision Photophobia RUQ/epigastric pain

Answer 69

Hemolysis Elevated liver enzymes Low platelets

Answer 70

Pulmonary edema Renal/liver failure DIC Placental abruption Acute respiratory syndrome Sepsis Stroke Fetal/maternal death

Answer 71

DTR +3 Clonus >3 beats (uncontrollable shaking)

Answer 72

Excessive vomiting with ketosis dehydration electrolyte imbalance Acetonia

Answer 73

Light spotting Mild cramping Bed rest

Answer 74

Moderate bleeding Mild severe cramping Cervix dilated

Answer 75

Heavy, profuse bleeding Severe cramping Tissue passed

Answer 76

Slight bleeding Mild cramps Cervix closes after tissue passed

Answer 77

Spotting No cramping Cervix not open

Answer 78

95% in fallopian tubes Other sites: ovary, abd cavity, cervix Can lead to infertility

Answer 79

Abd pain- referred shoulder pain Delayed menses or abnormal vaginal bleeding- gush of blood possible Pain may stop Hypovolemia

Answer 80

Methotrexate

Answer 81

Remove all or part of fallopian tube

Answer 82

Remove products of conception and then repair fallopian tubes

Answer 83

surgical placement of tape around uterine isthmus to help prevent abortion @11-13wks

Answer 84

Bed rest Tocolytics Progesterone Anti inflammatory drugs Abts Hydration If cervix opens- pregnancy can’t be saved

Answer 85

Previous hx Multiples Gestational diabetes Adv maternal age Obesity 2nd trimester bleeding African American Low prepreg wt UTIs

Answer 86

Contractions every 10 min or less for 1hr or more Lower Abd cramps Intermittent lower back pain Suprapubic pain or pressure Pelvic pain/pressure Leukorrhea Rupture of amniotic membranes Signs of UTI

Answer 87

Cardiac stress due to increased bld volume Preterm labor and postpartum hemorrhage due to over distention of uterus Placental previa or abruption due to placement Surgical delivery due to malpresentation

Answer 88

Prior c section Suction curettage Large placenta

Answer 89

Painless Bright red vaginal bleeding

Answer 90

Preterm birth, congenital anomalies Excessive bright red blood- no vaginal exams

Answer 91

Premature separation from implantation site >20wks

Answer 92

Vaginal bleeding Abd pain Rigid-board like fundus Uterine contractions Hypertonus (overly contracted) Port-wine stained amniotic fluid

Answer 93

HTN with that pregnancy Abd trauma Cig smoking Alcohol Cocaine Blood clotting disorders Diabetes Previous hx

Answer 94

Widespread external and internal bleeding with unrelated clot formation in other bld vessels

Answer 95

Severe preeclampsia HELLP Hemorrhage Hypoxia Shock Endothelial damage Gram negative sepsis

Answer 96

Petechiae Purpura Mucous membrane bleeding Bleeding from every break in skin

Answer 97

Replace blood and clotting factors

Answer 98

Dysuria, Frequency and urgency

Answer 99

Dysuria, Frequency and urgency

Answer 100

Mostly develops in 2nd trimester Hospitalization possible

Answer 101

Screening for neural tube defects and Abd wall anomalies

Answer 102

HcG Unconjugated estriol Inhibin A

Answer 103

AFP hcG UE3

Answer 104

For fetal rH status, fetal gender, paternally transmitted single gene disorders

Answer 105

Vibrating sound stimulus on Abd to induce FHR accelerations

Answer 106

Count Once a day for 60 min 2-3 times daily 10 movements in a 2hr period optimal

Answer 107

Indicates blood flow and oxygen to fetus is adequate FHR at least 15 beats above baseline 2 times in 20 min

Answer 108

May indicate fetal distress due to problems with placenta or umbilical cord Follow-up with BPP to determine if poor oxygenation or not

Answer 109

Pattern of at least 3 cx in 20 min lasting 40-60 sec

Answer 110

No late decelerations NORMAL

Answer 111

Late decelerations with cx (STRESSED/placental insufficiency)

Answer 112

Fluctuations in baseline FHR

Answer 113

No variability BAD

Answer 114

<5 bpm Baby sleeping/meds-narcotic?

Answer 115

6-25 bpm variability NORMAL

Answer 116

>25 bpm STRESSED BABY

Answer 117

>160 bpm Early sign of fetal hypoxemia, maternal fever/infection or fetal anemia

Answer 118

<110 bpm Usually caused by fetal cardiac problems such as structural defects, viral infections, maternal hypoglycemia and hypothermia

Answer 119

<30 sec of at least >15 bpm above baseline with return to baseline within 2 min NORMAL more than 10 min= change in baseline

Answer 120

Gradual decrease and return to baseline during cx Causes by fetal head compression

Answer 121

Gradual decrease in and return to baseline FHR The decrease starts AFTER cx already started Placental insufficiency

Answer 122

Transient hypoxemia- supine hypotension Epidural Placenta previa/abruption Post term gestation DM Stop pitocin, change position, O2 10L and elevate legs

Answer 123

Abrupt decrease in FHR Caused by cord compression Stop pitocin, change position, O2 10L

Answer 124

Variable decelerations >2 min

Answer 125

Removal of small tissue specimen from fetal portion of placenta Performed @10-13 wks

Answer 126

Vaginally- premature rupture of membranes, spontaneous abortion Abdominal- more invasive, can cause premature labor or rupture of membranes

Answer 127

Direct access to fetal circulation Insert of needle directly into fetal umbilical vessel under ultrasound guidance

Answer 128

Genetic concerns (adv age and hx) Fetal hemolytic disease Fetal maturity (L/S and S/A ratios)

Answer 129

Hemorrhage Feto-client hemorrhage Infection Labor Abrupto placenta Damage to intestines or bladder Amniotic fluid embolism

Answer 130

Death Hemorrhage Infection (amniotitis) Injury from needle

Answer 131

1hr test @ 24-28 wks If >130-140, 3hr GTT done. If >180, Dx

Answer 132

Obesity Fam hx >35 yrs old Prev infant >9lbs @ birth

Answer 133

Macrosomia Prematurity Respiratory distress Malformations of skeleta, CNS and cardio system

Answer 134

1st trimester- reduced need 2nd trimester- begin to increase 3rd trimester- may increase 2-4c more Birth- decreases Breastfeeding- up to 25% lower needs

Answer 135

Measures pressure changes with cx

Answer 136

Records FHR

Answer 137

Back of head

Answer 138

Passenger- fetus Passageway-birth canal Powers- contractions Position of the mother Physhological response

Answer 139

Vertex/cephalic

Answer 140

Transverse

Answer 141

Longitudinal or vertical

Answer 142

Head position (flexed/extended)

Answer 143

relation of fetal head to maternal pelvis ROP, LOP, ROA, LOA, transverse

Answer 144

Head forward and back against right hip

Answer 145

Head forward and back against left hip

Answer 146

Back against rt hip and head facing towards moms back

Answer 147

FAVORABLE back against left hip and head towards moms back

Answer 148

External opening to vagina

Answer 149

Effacement Dilation Ferguson reflex

Answer 150

Bearing down

Answer 151

Gravity Medical intervention

Answer 152

Onset of contractions to full dilation of cervix Early: 3-8hrs long Active: 3-7hrs long FHR tracing every 30 min

Answer 153

Up to 5cm dilation Cx 30-45 sec every 5-20 min

Answer 154

6-10 cm dilated Cx 40-70 sec every 3-5 min

Answer 155

Full dilation to birth FHR monitoring q15 min 10-60 min Active pushing and bearing down

Answer 156

Birth of fetus to delivery of placenta 5-20 min Sudden gush of dark blood and fluid Lengthening of umbilical cord Vaginal fullness

Answer 157

2hrs post delivery of placenta

Answer 158

1. Engagement and decent 2. Flexion 3. Internal rotation 4. Extension 5. Restitution 6. External rotation 7. Expulsion (birth)

Answer 159

Anybody can deliver a baby in a hospital Can’t turn them away

Answer 160

Don’t use if drug dependent- will cause withdrawal symptoms in mother and/or neonate Check dilation before giving (<8cm)

Answer 161

Used to numb perineal area for episiotomy No SE unless allergy

Answer 162

Hypotension and headache (CSF leak)

Answer 163

Late in 2nd stage of labor Helpful in episiotomy Forceps used or vacuum

Answer 164

Opioid for mod-severe labor pain & post op c section SE: FHR temporarily absent or minimal, HTN

Answer 165

Yawning Runny nose Sweating Mydriasis (dilation of pupils) Irritability Tremors Chills/hot flashes Piloerection Violent sneezing Bone/muscle pain

Answer 166

Provides accurate measurement of intensity of cx For amnioinfusion Amniotic sac must be ruptured

Answer 167

Accurate FHR Amniotic sac must be ruptured Must be attached to bony part of head

Answer 168

Should be clear or meconium stained (brown/green) with no odor

Answer 169

Rapid descent in FHR Trendelenburg position Emergency c section

Answer 170

Assessing fetal response to cx Pitocin started- 3 contractions in 10 min Positive= decels (follow up with BPP) Negative= no decels

Answer 171

Inadequate fetal growth

Answer 172

Hx of preterm birth African American Genital tract infections Multiples 2nd trimester bleeding Low preg wt

Answer 173

Fetal fibronectin-binder-vaginal swab @22-34 wks

Answer 174

Rupture before 37 wks Infection major risk 1 hr before labor

Answer 175

Bacterial infection of amniotic cavity

Answer 176

Maternal fever Fetal tachycardia Uterine tenderness Foul odor of amniotic fluid

Answer 177

Dysfunctional labor, macrosomia, hemorrhage, infection Fetal risks- macrosomia, oligohydraminos from aging Most MDs induce @41 wks

Answer 178

Long difficult abnormal labor Ineffective uterine contractions, abnormal presentation, position or development, abnormalities of pelvic or reproductive tract

Answer 179

Labor less than 3hrs with or without augmentation

Answer 180

Effective >39 wks Bishop score must be a 6 or more

Answer 181

Unfavorable fetal position Maternal oliguria Placenta previa Active herpes Macrosomia Fetal distress Early preterm labor

Answer 182

Placental abruption Uterine rupture Unnecessary c section Postpartum hemorrhage Infection Fetal hypoxemia and academia

Answer 183

Used when 2nd stage is prolonged Fetal indications- abnormal FHR, abnormal presentation (breech)

Answer 184

Cup attached to head using neg pressure Prereqs: 10 cm dilated, engaged head/vertex presentation, ruptured membranes, no suspicion of CPD

Answer 185

Biggest risk- uterine rupture Trial of labor done first

Answer 186

Hx of vertical incision in uterus >3 c sections Complications present Previous uterine injury

Answer 187

Fetus passed first stool before birth Fluid thin and light green Indent risk of meconium aspiration- intubate to suction meconium below cords before 1st breath

Answer 188

Head born and shoulder is stuck under pubic arch McRoberts maneuver- flex moms knees to shoulder to shorten birth canal

Answer 189

Cord below fetal presentation Long cord >100 cm Breech presentation, transverse lie

Answer 190

Multiple c sections (separation of scar) Multiples Macrosomia Induced labor No prev vag births Congenital uterine anomaly Uterine trauma Forceps delivery Infection

Answer 191

Abnormal FHR and loss of contraction tracing Tetany of uterine muscle Loss of fetal station Abd pain/shock

Answer 192

Fluid contains particles of debris

Answer 193

Acute hypotension Hypoxia Cardio collapse Coagulopathy Neonatal outcome poor and maternal mortality high

Answer 194

Indication: labor >4 cm Mg sulfate given to reduce/prevent neonatal neurological sequelae Neonatal CPR

Answer 195

Dark line=1 min

Answer 196

FHR change associated with cx

Answer 197

Not associated with cx

Answer 198

Reduces cord compression Infused @room temp, isotonic fluid into uterine cavity if volume of amniotic fluid is low Fluid administered through IUPC

Answer 199

Over distention of uterine cavity and increased uterine tone

Answer 200

Toxoplasmosis other infections (syphilus, HBV, HIV, parvovirus, west Nile and Zika) Rubella cytomegalovirus herpes simplex Capable of crossing the placenta Produce influenza like symptoms

Answer 201

Tests for ruptured membrane Low ph: membranes probably intact 5-6 Higher ph: membranes probably ruptured 6.5-7.5

Answer 202

Fetal breathing movement Fetal tone Amniotic fluid volume

Answer 203

Increased fundal height Excessive N/V Scant dark discharge in 2nd trimester