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OB - Napier > Exam 1 blueprint > Flashcards

Exam 1 blueprint Flashcards

1
Q

what causes urinary frequency during pregnancy?

A

uterus pressing on the bladder

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2
Q

how is fundal height measured?

A

from symphysis pubis to the top of the fundus (in cm)

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3
Q

where should the fundus measure at 20 weeks?

A

in line with the umbilicus

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4
Q

what should be used to prevent neural tube defects?

A

folic acid supplements
(400 mcg at childbearing age and 600 mcg once pregnant)

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5
Q

what neural tube defect is characterized by incomplete development of the fetal skull and brain?

A

anencephaly

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6
Q

which neural tube defect is characterized by an open spine?

A

spina bifida

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7
Q

which neural tube defect is a defect of the abdominal wall?

A

omphalocele

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8
Q

what surgical intervention is utilized for reduced cervical competence?

A

cerclage

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9
Q

what s/s should a patient report following a cerclage?

A

report pain, increased pressure, ROM and s/s of infection

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10
Q

what is the antidote for magnesium sulfate?

A

calcium gluconate

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11
Q

what complication of magnesium administration would cause absence of DTR or RR < 12/min?

A

toxicity

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12
Q

what does the BURP mnemonic stand for for magnesium sulfate toxicity?

A

B - BP decreased
U - UOP decreased
R - RR < 12
P - patellar reflex absent

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13
Q

what are the indications for magnesium sulfate?

A

eclampsia and severe eclampsia (seizures)

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14
Q

what type of abortion is characterized by no dilation or passage of tissue and slight bleeding, where pregnancy may continue?

A

threatened abortion

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15
Q

what type of abortion is characterized by dilation of the cervix, moderate bleeding w/cramping, and definite loss of pregnancy?

A

inevitable abortion

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16
Q

what type of abortion has retained tissue that causes continued bleeding and possible infection, as well as passage of some tissue, bleeding, cramping and dilation of cervix?

A

incomplete abortion

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17
Q

what is a complete abortion?

A

all pregnancy tissue passes through the dilated cervix

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18
Q

what is a missed abortion?

A

fetus has died (no heart beat), no bleeding or spotting

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19
Q

what is a septic abortion?

A

severe infection following an abortion that causes a malodorous discharge

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20
Q

what causes supine hypotension?

A

weight of the gravid uterus compressing the vena cava, reducing the blood supply

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21
Q

how can supine hypotension be alleviated?

A

lay on side

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22
Q

what type of sign of pregnancy is a positive pregnancy test?

A

probable

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23
Q

what may cause a false positive pregnancy test?

A

a hormone secreting tumor

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24
Q

about what week can quickening be felt?

A

around 20 weeks

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25
Q

what area is most likely to be damaged during childbirth?

A

perineum (between vaginal opening and anus)

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26
Q

what is suspected if a female of childbearing age complains of unilateral stabbing pain, red/brown spotting and referred pain in the shoulder?

A

ectopic pregnancy

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27
Q

what medication may be administered for the treatment of a non-ruptured ectopic pregnancy?

A

methotrexate

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28
Q

what treatment measure is indicated for a ruptured ectopic pregnancy?

A

laparoscopic salpingectomy (removal of tube)

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29
Q

what pregnancy complication is characterized by very painful, dark
red vaginal bleeding, contractions and a board-like abdomen?

A

placental abruption

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30
Q

which pregnancy complication is characterized by painless, bright red vaginal bleeding after 20 weeks?

A

placenta previa

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31
Q

how is placenta previa diagnosed?

A

ultrasound

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32
Q

what must be avoided if placenta previa is suspected or diagnosed?

A

NOTHING in vagina (no vaginal exams or sexual intercourse)

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33
Q

what type of birth is indicated for those with placenta previa?

A

cesarean

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34
Q

what is a medication given for mothers with placenta previa if less than 34 weeks?
why?

A

betamethasone
promote fetal lung maturity

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35
Q

what should be immediately applied to the mother who is having a placental abruption to monitor the status of the fetus?

A

EFM (electronic fetal monitor)

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36
Q

what is the earliest genetic testing available?

A

CVS (chorionic villus sampling)

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37
Q

when can a CVS be performed?

A

10 - 13 weeks

38
Q

why should the nurse instruct the mother to drink 1 -2 glasses of water prior to the CVS testing?

A

a full bladder is necessary

39
Q

which genetic testing is performed by a passing a catheter through the cervix and into the uterus or through abdominal wall and obtaining a sample of the finger-like projections of the developing placenta?

A

CVS (chorionic villus sampling)

40
Q

why may a CVS be performed?

A

if the mother is at risk for giving birth to a neonate with a genetic chromosomal abnormality

41
Q

when can an amniocentesis be performed?

A

15 weeks to birth

42
Q

when can the AFP (alpha fetoprotein) test be performed?

A

15 - 18 weeks

43
Q

what may a high level of AFP indicate?

A

neural tube defect or open abdominal defect

44
Q

what may a low level of AFP indicate?

A

down syndrome

45
Q

when may a targeted ultrasound be performed?

A

after 18 weeks

46
Q

which genetic test is characterized by a complete scan of the fetal anatomy to assess for potential genetic abnormalities?

A

Level II ultrasound/targeted ultrasound

47
Q

what are the signs of hemorrhage that may be seen as a result of placental abruption?

A
  • tachycardia
  • hypotension
  • pallor
  • tachypnea
48
Q

what is the first line management of placental abruption?

A

immediate birth

49
Q

what are the nursing interventions for placental abruption?

A
  • palpate uterus for tenderness/tone
  • serial monitoring of fundal height
  • assess FHR pattern
  • emotional support
50
Q

what medication is given to dissolve the pregnancy of a non ruptured ectopic pregnancy?

A

methotrexate

51
Q

what may indicate that an ectopic pregnancy has ruptured?

A

red vaginal bleeding and potential signs of hemorrhage

52
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- amenorrhea

A

presumptive

53
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- N/V and fatigue

A

presumptive

54
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- urinary frequency or breast changes

A

presumptive

55
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- quickening

A

presumptive

56
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- uterine enlargement

A

presumptive

57
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- positive pregnancy test

A

probable

58
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- abdominal enlargement

A

probable

59
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- Chadwick’s sign (bluish color of vulva, vagina, cervix)

A

probable

60
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- auscultation of fetal heart sounds

A

positive

61
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- fetal movement felt by examiner

A

positive

62
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- visualization of fetus by examiner

A

positive

63
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- deliver of the baby

A

positive

64
Q

Determine whether it is a presumptive, probable or positive sign of pregnancy?
- Hegar’s sign (softening of cervix)

A

probable

65
Q

what result is indicative of a reactive non-stress test?

A

FHR increases at least 15/min for at least 15 seconds and occurs at twice during a 20 min period

66
Q

what do 2 or more accelerations within 20 mins indicate for a non-stress test?

A

reactive

67
Q

what type of test may be indicated for a nonreactive non-stress test?

A

BPP (biophysical profile)

68
Q

what indicates that a non-stress test is nonreactive?

A

there are not 2 accelerations within the 20 minute window

69
Q

is a negative CST normal or abnormal?

A

normal

70
Q

is a positive CST normal or abnormal?

A

abnormal

71
Q

what test combines a non-stress test and fetal ultrasound?

A

BPP (biophysical profile)

72
Q

besides a nonreactive non-stress test, what are 3 indications for a biophysical profile?

A
  • suspected oligohydramnios
  • suspected polyhydramnios
  • suspected fetal hypoxia
73
Q

what are the 5 variables of a biophysical profile?

A
  • FHR
  • fetal breathing movements
  • gross body movements
  • fetal tone
  • qualitative amniotic fluid volume
74
Q

what is a normal score of the BPP?

A

8-10

75
Q

What is G in GTPAL?

A

Gravidy (number of pregnancies, regardless of outcome)

76
Q

What is T in GTPAL?

A

Term (number of pregnancies delivered past 37 weeks)

77
Q

What is P in GTPAL?

A

Preterm (delivered before 37 weeks)

78
Q

What is A in GTPAL?

A

Abortion (pregnancy ended before 20 weeks)

79
Q

What is L in GTPAL?

A

Living (how many are alive now)

80
Q

What is L in GTPAL?

A

Living (how many are alive now)

81
Q

when may macrosomia occur?

A

gestational diabetes

82
Q

what complication may occur as a result of uncontrolled diabetes?

A

fetal demise
(vasoconstriction reduces blood flow/oxygen/nutrients to baby)

83
Q

does gestational hypertension have proteinuria?

A

NO

84
Q

what diagnosis is suspected for a patient who has a BP of 160/90 and 3+ protein in urine?

A

preeclampsia

85
Q

what diagnosis is suspected for a mother at 25 weeks gestation with BP 144/95 and no protein detected by UA?

A

gestational hypertension

86
Q

what is indicated by 160/110 and >3+ proteinuria?

A

severe preeclampsia

87
Q

what is necessary for the treatment of class A2 gestational diabetes?

A

medications

87
Q

how is class A1 gestational diabetes managed?

A

diet

88
Q

what BG value for a 1hr GTT indicates the need for a 3hr GTT?

A

130-140

89
Q

what is indicated if 3 or more of the values collected during a 3 hr glucose tolerance test are elevated?

A

gestational diabetes diagnosis

90
Q

what is the gold standard intervention for diabetics to reduce perinatal mortality and reduce to the prevalence of congenital anomalies?

A

preconception counseling

OB - Napier (2 decks)

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