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OB - Napier > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

what causes frequent urination in pregnancy?

A
  • anatomical positioning causing the uterus to press on the bladder all the time
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2
Q

what is the primary mechanism to stop hemorrhage from the uterine arteries after childbirth?

A

contraction of the uterine smooth muscles to compress the arteries

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3
Q

what is considered the first day of the menstrual cycle?

A

first day of bleeding during menses

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4
Q

what does progesterone do to endometrial lining?

A
  • causes thickening of endometrial lining to prepare for implanting of a fertilized egg
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5
Q

what does progesterone do to smooth muscle?

A
  • relaxes smooth muscle to allow the uterus to grow during pregnancy
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6
Q

what happens to the endometrium when progesterone levels drop?

A

the thickened endometrium sheds in menses

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7
Q

what happens to BBT (basal body temp) during ovulation?

A

drops slightly and then spikes 1/2 a degree

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8
Q

what hormone spikes during ovulation?

A

LH

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9
Q

what does the cervical mucus do during ovulation?

A

appears thin, clear and stretches like eggs whites
- known as Spinnbarkeit Sign

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10
Q

which hormone decreases to trigger a period?

A

progesterone

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11
Q

what is an expected finding of dizygotic twins?

A

different genders

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12
Q

which stage of fetal development is most vulnerable to medications and chemicals?

A

embryonic

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13
Q

what finding would indicate progression of gestational hypertension to eclampsia?

A
  • new onset of seizures
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14
Q

what is the priority action for painless vaginal bleeding?

A

obtain an ultrasound

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15
Q

what does the umbilical artery do?

A

carry stuff from the baby to the mom

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16
Q

what do the umbilical veins do?

A

carry stuff to the baby from the mom

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17
Q

what does a UA in pregnancy look at?

A
  • specific gravity color
  • glucose
  • protein, nitrates, casts, acetone
  • RBC and WBC
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18
Q

what are the parameters for a 3 hr glucose tolerance test?

A
  • fasting >95
  • 1 hr >180
  • 2 hr> 155
  • 3hr > 140
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19
Q

what substance within the uterus prevents compression of the umbilical cord?

A

amniotic fluid

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20
Q

what prevents the skin of the fetus from adhering to the wall of the amniotic sac?

A

amniotic fluid

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21
Q

what are 3 functions of the amniotic sac?

A
  • protects baby
  • allows baby to move
  • controls baby’s temp
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22
Q

what substances are risk factors for placental abruptions?

A
  • cocaine, smoking/tobacco
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23
Q

what type of trauma places the mother at risk for placental abruption?

A

penetrating or blunt abdominal trauma

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24
Q

what type of deficiency may lead to placental abruptions?

A

folate deficiency

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25
Q

what BP abnormality may cause a placental abruption?

A

hypertension

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26
Q

what is the primary nursing concern for a patient who has preeclampsia and develops hyperreflexia?

A

seizures

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27
Q

what is the diagnosis for a preeclamptic patient who has had a seizure?

A

eclampsia

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28
Q

what precautions are necessary for a patient who is on seizure precautions?

A
  • pad side rails
  • keep O2 nearby
  • stay w/patient
  • suction available
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29
Q

what part of the pregnancy would we screen for gestational diabetes?

A

24-28 weeks

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30
Q

what part of pregnancy would we obtain a GBS (group B strep) swab?

A

35-37 weeks

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31
Q

what med is given for a patient who is in labor and has tested positive for GBS?

A

ampicillin

2mg of amp is given, then 1 mg Q 4h

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32
Q

what is given for GBS if patient is allergic to PCN?

A

clindamycin

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33
Q

what medication is expected to be prescribed for a patient who has had recurrent miscarriages?

A

progesterone

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34
Q

what are some foods high in folic acid?

A
  • spinach
  • artichokes
  • cereals, seeds, nuts
  • liver
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35
Q

what result at 24 weeks gestation would require immediate action?

A

positive RPR (syphilis)

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36
Q

when would the next routine appointment be for a low risk mother who is 34 weeks gestation?

A

in 2 weeks

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37
Q

what is the name for the fingerlike projections that become the placenta?

A

chorionic villi

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38
Q

what is the solid ball of cells before implantation called?

A

morula

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39
Q

what is the hollow ball of cells that implants into the uterus called?

A

blastocyst

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40
Q

what do trophoblasts do?

A

creates placental tissue

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41
Q

if fertilization and implantation don’t occur, what hormone changes would trigger menses?

A
  • decrease in progesterone
  • decrease in estrogen
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42
Q

which period of development would be most vulnerable to effects from alcohol?

A

embryonic

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43
Q

how long should a normal pregnancy last?

A

about 280 days from the first day of the last normal menstrual period

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44
Q

a nurse is caring for a client following fetal demise. the client is crying and saying “i tried to get pregnant for so long. my partner and I wanted this baby so much. Now, what will we do?” what response should the nurse provide?

A

“are you feeling overwhelmed?”

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45
Q

what is the most common gestational complication?

A

hypertension

46
Q

what is considered gestational hypertension?

A
  • BP > 140/90
  • onset after 20 weeks
47
Q

which condition is marked by gestational hypertension (BP > 140/90) and proteinuria?

A

preeclampsia

48
Q

which gestational complication involves preeclampsia and seizures seizures?

A

eclampsia

49
Q

why is it important to closely monitor the mother with preeclampsia for 48 hr after birth?

A

1/3 of eclamptic seizures occur after delivery

50
Q

what condition is characterized by hypertension that is present prior to 20 weeks gestation or that lasts longer than 12 weeks postpartum?

A

chronic hypertension

51
Q

why may a patient with preeclampsia experience RUQ pain?

A

decreased liver perfusion leading to impaired liver function (elevated liver enzymes)

52
Q

what do decreased/absent DTRs, decreased respirations and cardiac arrest indicate for magnesium administration?

A

toxicity

53
Q

what is a priority action for a nurse for a patient with eclampsia having a seizure?

A

DO NOT leave the bedside
- padded side rails
- head to one side
- suction

54
Q

what are 3 defining characteristics of hyperemesis gravidarum that differentiate it from the normal n/v that is seen in up to 80% of all pregnancies?

A
  • weight loss
  • fluid/elec imbalances
  • nutritional deficits
55
Q

which pregnancy abnormality causes a concern for fetal development due to insufficient space for the fetus to grow as well as extremities sticking to each other in the early stages of pregnancy?

A

oligohydramnios

56
Q

when is polyhydramnios likely to be seen?

A

in pregnancies with gestational diabetes

57
Q

what is a normal amniotic fluid index?

A

10 - 25

58
Q

what point is every organ system present during fetal development?

A

week 8 (every organ system is present, just nit mature)

59
Q

what are 3 characteristics seen on fetus at 20 weeks?

A
  • breathing movements
  • vernix caseosa
  • lanugo
60
Q

what term describes identical twins?

A

monozygotic
- 1 egg, 1 sperm

61
Q

what term describes fraternal twins?

A

dizygotic

62
Q

what is a potential problem with twins sharing the same placenta?

A

twin to twin transfusion syndrome (baby A gets more than baby B, so its larger)

63
Q

what type of twins can twin to twin transfusion syndrome occur with?
(mono or dizygotic?)

A

monozygotic

64
Q

what may increase the chance of the mother having dizygotic twins?

A

fertility drugs

65
Q

what is known as the softening and compressibility of the lower uterus?

A

Hegar’s sign (probable)

66
Q

what is chadwicks sign?

A

violet-bluish color of cervical and vaginal mucosa

67
Q

what is known as softening of the cervical tip?

A

Goodell’s sign

68
Q

how does naegeles rule work?

A

subtract 3 months form the first day of the client’s last menstrual period, add a week and 1 year

69
Q

what anatomical landmark is the halfway mark for fundal height during a pregnancy?

A

mother’s umbilicus

70
Q

what is preferred position for alleviation of supine hypotension?

A

left lateral

71
Q

what role does progesterone have in the occurrence of heartburn/indigestion in pregnancy?

A

progesterone relaxes the sphincter causing food to reflux

72
Q

what is chloasma?

A

increase of pigmentation on the face during pregnancy

73
Q

what education should be provided for the mother who has developed chloasma?

A
  • sunscreen
  • shade
  • sun hats
74
Q

what is the linea nigra?

A

dark line of pigmentation from the umbilicus extending to pubic area that occurs during pregnancy

75
Q

what is striae gravidarum?

A

stretch marks that occur during pregnancy

76
Q

what is expected weight gain during pregnancy?

A

25-35 lbs

77
Q

what may reduce n/v in pregnancy?

A

small frequent meals

78
Q

what does polyhydramnios do to fundal height?

A

increases it more than what is expected

79
Q

what does polyhydramnios do to pregnancy weight gain?

A

increases the weight gain amount

80
Q

what may cause oligohydramnios?

A

gestational hypertension

81
Q

what fetal conditions may be seen as a result of polyhydramnios?

A
  • gastrointestinal malformations
  • neurological disorders
82
Q

what should be given to clients who are in labor and have tested for GBS?

A

prophylactic antibiotics

83
Q

what should the patient do prior to amniocentesis?

A

empty their bladder

84
Q

what is a threatened abortion?

A
  • no dilation
  • no tissue passed
  • preg may continue
85
Q

what is an inevitable abortion?

A
  • dilation of cervix
  • definite loss of preg
86
Q

what is an incomplete abortion?

A
  • passage of some tissue
87
Q

what is considered a complete abortion?

A
  • all tissue passed through dilated cervix
88
Q

what is a missed abortion?

A

fetus has died

89
Q

what are the manifestations of reduced cervical competence?

A

painless dilation through 2nd trimester

90
Q

what are the diagnostic criteria for reduced cervical competence?

A
  • Hx of 2nd trimester losses
  • short cervix (<25mm)
91
Q

what may a sudden gush of fluid from the vagina indicate in a patient who has had a cerclage?

A

possible rupture of membranes (this should be reported)

92
Q

what must be avoided if patient has an unruptured ectopic pregnancy?

A
  • avoid drinking alcohol and vitamins w/folic acid
93
Q

what is a salpingotomy?

A

removal of ectopic pregnancy while keeping tube intact

94
Q

why should serum hCG be checked weekly for 3 weeks and then monthly for 6 months following a hydatidiform mole (molar pregnancy)?

A

to ensure that all of the molar tissue is gone

95
Q

what are 4 common symptoms of UTI in pregnancy?

A
  • dysuria
  • hematuria
  • back pain (CVAT)
  • contractions
96
Q

why is it essential for mothers to have frequent screening for UTI during pregnancy?

A

UTI can induce preterm labor

97
Q

does insulin pass the through the placenta from mom to baby?

A

no

98
Q

what is the desired fetal movement counting?

A

ten movements within a 1-2 hr window

99
Q

what subjective maternal report may indicative of fetal death?

A

a reported absence of fetal movement

100
Q

what fetal position is preferred for birth?

A

OA (occiput anterior)

101
Q

how many accelerations are expected within 20 mins for a non stress test?

A

2

102
Q

what are the 5 components of the BPP?

A
  • FHR
  • breathing
  • movement
  • tone
  • amniotic fluid amount
103
Q

what does a BPP score of 4 or less indicate?

A
  • consider immediate delivery
104
Q

what should be considered for a BPP of 6?

A

consider delivery if at term

105
Q

what is HELLP syndrome?

A

severe preeclampsia +
- hemolysis
- elevated liver enzymes
- low platelets

106
Q

what is an expected finding for the hemoglobin of a mother who has had preeclampsia that has progressed into HELLP syndrome?

A

decreased hemoglobin levels (hemolysis)

107
Q

The client with eclampsia has just had a tonic-clonic seizure. after turning the clients head to the side what action should the nurse take?

A

given oxygen 10L/min via face mask

108
Q

what is an expected adverse effect of magnesium infusion?
why?

A

feeling of warmth all over

109
Q

what assessment data is the most accurate indicator of fluid electrolyte imbalance for a client with preeclampsia?

A

daily weight

110
Q

what are the 5 adaptations of fetal circulation?

A
  • placenta
  • umbilical vein
  • ductus venosus
  • foramen ovale
  • ductus arteriosus
  • umbilical artery

OB - Napier (2 decks)

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