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OB Final Exam > Exam 1 Content > Flashcards

Exam 1 Content Flashcards

1
Q

Gravida (G)

KNOW THIS!!!!!

A

Total number of confirmed pregnancies

  • regardless of whether the pregnancies resulted in birth, miscarraige, abortion, or ectopic pregnancy
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2
Q

Para (P)

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A

Number of pregnancies in which the fetus or fetuses have reached 20 weeks gestation

*

Para has 4 categories:
* Term (T)
* Preterm (P)
* Abortion (A)
* Living (L)

  • NOT the number of individual fetuses (twins = 1 pregnancy)
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3
Q

Term (T)

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Can also be “F” for full term

A

Number of pregnacies resulting in full term birth
* 37+ weeks gestation

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4
Q

Preterm (P)

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A

Number of pregnancies resulting in preterm birth
* 20 - 36 weeks gestation

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5
Q

Abortion (A)

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A

Number of pregnancies that ended BEFORE 20 weeks gestation

  • due to miscarraige or elective abortion
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6
Q

Living (L)

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A

Number of currently living children the woman has

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7
Q

How many weeks is considered full term?

KNOW THIS!!!!!

A

37+ weeks gestation

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8
Q

How many weeks is considered a pre-term birth?

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A

20 - 36 weeks gestation

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9
Q

An abortion is a pregnancy that ends before how many weeks gestation?

KNOW THIS!!!!!

A

BEFORE 20 weeks gestation

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10
Q

Define each trimester

A

First Trimester
* 1 - 13 weeks

Second Trimester
* 14 - 26 weeks

Third Trimester
* 27 - 40 weeks

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11
Q

What is EDC?

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A

Estimated Date of Confinement
* due date

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12
Q

Naegle’s Rule

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A

Used to determine estimated date of birth

  • date of LMP - 3 months + 7 days
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13
Q

Primigravida

A

First pregnancy

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14
Q

Multigravida

A

2 or more pregnancies

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15
Q

Precipitous Birth

A

Quick birth
* onset to birth is less than 3 hours (from time water breaks to birth of the baby)

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16
Q

What is the postpartum period?

A

From delivery of the placenta to the return of the reproductive system to the non-pregnant state

  • usually 6-8 weeks
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17
Q

Prenatal Visit Schedule

A
  • First visit within first trimester (12 weeks)
  • Monthly visits between 16 - 28 weeks
  • Visits every 2 weeks from 29 - 36 weeks
  • Weekly visits from 36 weeks until birth
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18
Q

What is involution?

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A

When the uterus returns to pre-birth state
* within 12 hours palpate the fundus 1 cm above the umbilicus; make sure the bladder is empty

  • by 2 weeks the fundus should NOT be palpable
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19
Q

When should the fundus no longer be palpable after birth?

KNOW THIS!!!!

A

2 weeks

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20
Q

What is subinvolution?

KNOW THIS!!!!!

A

Uterus fails to return to pre-pregnancy state / size

  • caused by retained placental fragments & infection
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21
Q

There is an increased risk of what if the placenta is left inside the body and not all segments are removed?

KNOW THIS!!!!!

A

Risk of hemorrhage

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22
Q

Lochia

KNOW THIS!!!!!

A

Combination of blood, mucus, & tissue discharged from the uterine lining
* 3 types: rubra, serosa, alba

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23
Q

Lochia Rubra

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A
  • Rubra = Ruby Red
  • 1-3 days
  • May have small clots

  • Reddish or red-brown vaginal discharge that occurs immediately after childbirth
  • mostly composed of blood with clots (grape sized clots)
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24
Q

Lochia Serosa

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A
  • Pinkish brown
  • 4 - 10 days after delivery

  • pink, serous, or blood-tinged vaginal discharge
  • pinkish / brown
  • little to no clotting
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25
Q

Lochia Alba

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A
  • Whitish yellow
  • 10 - 14 days
  • Can last 3 - 6 weeks

  • White, cream-colored, or yellow vaginal discharge that occurs 10 days but can last up to 6+ weeks after delivery
  • contains WBCs
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26
Q

What are the 3 types of lochia & how long do they last?

KNOW THIS!!!!!

A

Really Sore After

Lochia Rubra
* Ruby Red
* 1-3 days

Lochia Serosa
* Serous / pink-ish
* 3 - 10 days

Lochia Alba
* white / cream-colored
* 10 - 14 days; may be up to 6 weeks

Really Sore After

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27
Q

Mnemonic for types of Lochia

A
  • Really
  • Sore
  • After

Really = Rubra (1-3 days; ruby red)

Sore = Serosa (4-10 days; pink/brown)

After = Alba (10-14 days but up to 3-6 weeks; white / yellow)

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28
Q

What is the normal Quantitative Blood Loss (QBL) for vaginal & c-section deliveries?

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A

Vaginal < 500 mL

C-Section = 1,000 mL

  • 1 g = 1 mL of blood
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29
Q

What might the presence of free-flowing, bright red blood indicate?

KNOW THIS!!!!!

A

Cervical laceration

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30
Q

Pregnancy is considered to be what type of state?

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A

Hypercoaguable

  • due to increased levels of fibrinogen & clotting factors
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31
Q

What is the most common postpartum complaint?

KNOW THIS!!!!!

A

HEADACHE

  • Tx = magnesium sulfate
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32
Q

Preeclampsia

KNOW THIS!!!!!

A

A complication of pregnancy characterized by:
* hypertension (↑ BP)
* edema
* proteinuria (protein in urine)

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33
Q

What is a common cause of excess bleeding?

KNOW THIS!!!!!

A

Uterine atony

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34
Q

What is uterine atony?

KNOW THIS!!!!!

A

Failure of the uterine muscle to contract

Tx: hemabate or methergine

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35
Q

What is the treatment for uterine atony?

KNOW THIS!!!!!

A

Hemabate or Methergine

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36
Q

Presumptive Signs of Pregnancy

KNOW THIS!!!!!

A

subjective changes experienced by the woman
* fatigue
* breast changes
* amenorrhea
* nausea / vomiting
* urinary frequency

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37
Q

Probable Signs of Pregnancy

KNOW THIS!!!!!

A

Objective changes observed / perceived by the examiner that strongly suggest pregnancy

  • positive pregnancy test
  • Hegar sign (softening of uterus)
  • Chadwick sign (bluish discoloration of cervix, vagina, labia due to increased blood flow to the area)
  • Braxton Hicks contractions
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38
Q

Positive Signs of Pregnancy

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A

Objective changes observed by the examiner that indicate proof of pregnancy

  • fetal heart tones
  • ultrasound
  • fetal movements visible / palpated by examiner
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39
Q

Beta hCG

A

Earliest marker of pregnancy
* can be detected in maternal serum or urine as soon as 7-8 days before expected menses

  • usually doubles every 2 days for first 4 weeks of pregnancy
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40
Q

What are the 4 types of thermal heat loss in a newborn?

KNOW THIS!!!!!

A
  • Conduction - loss of heat from body surface to cooler surface via direct contact
  • Convection - flow of heat from body surface to cooler air
  • Evaporation - liquid turns to vapor (dry baby immediately after birth)
  • Radiation - body heat is lost to the envirionment (window, fan, ac, cold walls, etc.)

  • COnvection = COol (air)
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41
Q

What are the 4 factors that stimulate initiation of respiration / breathing for a newborn?

KNOW THIS!!!!!

A
  • Chemical
  • Mechanical
  • Thermal
  • Sensory

  • Chemical = Contractions
  • Mechanical = pressure from labor pushing fluid out of the lungs
  • Thermal = womb temperature to outside temperature
  • Sensory = Suctioning / drying
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42
Q

What is the first organ system to develop in utero?

A

Cardiovascular

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43
Q

Non-shivering Thermogenesis

A

Use of brown fat to generate heat without muscle shivering

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44
Q

Normal Respiratory Rate

A

30 - 60 breaths per minute

  • tachy = over 60 bpm
  • brady = less than 30 bpm
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45
Q

Normal Fetal Heart Rate

A

120 - 160 bpm

46
Q

Normal Fetal Blood Pressure

A

75 - 95

over

25 - 45

47
Q

Newborn Voiding

A

Should void by 24 hours of life
* day 1 = 1 void
* day 2 = 2 voids
* etc.

48
Q

Meconium

A

First BM; passed within 12-24 hours of life

49
Q

Can maternal glucose cross the placenta in utero?

KNOW THIS!!!!

A

YES

50
Q

When are Apgar scores done?

KNOW THIS!!!!!

A

1, 5, & 10 minutes

  • can be done every 5 minutes up to 20 minutes
51
Q

What is the difference between newborn tremors & newborn seizures?

KNOW THIS!!!!!

A
  • Newborn Tremors or jitters will stop with gentle restraint
  • Newborn Seizures are uncontrolled electrical disturbances that do NOT stop with gentle restraint
52
Q

Do newborn seizures or newborn tremors stop with gentle restraint?

KNOW THIS!!!!!

A

Newborn tremors

53
Q

Chorioamnionitis

KNOW THIS!!!!!

A

Inflammation of amniotic sac (the chorion & amnion)

54
Q

Newborn Eye Prophylaxis

KNOW THIS!!!!!

A

Prevents gonorrhea tramsnission from mother to baby

  • erythromycin 0.5 - 1 mg within 1-2 hours of birth
55
Q

Vitamin K Injection

KNOW THIS!!!!!

A

Given to prevent hemorrhage because the baby’s gut is sterile

  • aquamephyton 0.5 - 1 mg IM
56
Q

AGA

KNOW THIS!!!!!

A

Appropriate for Gestational Age
* 50th percentile

57
Q

LGA

KNOW THIS!!!!!

A

Large for Gestational Age
* > 90th percentile

58
Q

SGA

KNOW THIS!!!!!

A

Small for Gestational Age
* < 10th percentile

59
Q

Caput Succedaneum

KNOW THIS!!!!!

A

generalized scalp swelling that CROSSES the suture line

  • common after vacuum assisted delivery
60
Q
A
61
Q

Who is Rh immune globulin administered to?

KNOW THIS!!!!!

A

Rh negative (Rh -) mothers

62
Q

What happens if an Rh- mother gives birth to an Rh+ fetus?

KNOW THIS!!!!!!

A

Rh immune globulin is repeated within 72 hours of birth

63
Q

What are the 5 P’s of Labor & Birth?

KNOW THIS!!!!!!

A
  • Passenger: fetus & placenta
  • Passageway: birth canal
  • Powers: contractions
  • Position of the laboring woman
  • Psychology / Psychological Response
64
Q

What 3 fetal indicators does Leopold’s Maneuver assess?

KNOW THIS!!!!!!

A
  • Fetal Presentation (breech, head down / vertex, shoulder etc.)
  • Fetal Lie (relation of fetus’ spine to mother’s spine)
  • Fetal Attitude (relation of fetal body parts to one another; usually flexed)
65
Q

Fetal Lie

A

**relationship of the spine **(long axis) of the fetus to the spine (long axis) of the mother

  • either longitudinal/vertical or transverse/horizontal or oblique
66
Q

Fetal Attitude

A

Relation of the fetus’ body parts to one another

  • usually in a flexed position
67
Q

Fetal Position

A

Describes the relationship of the presenting part of the baby to the 4 quadrants of the mother’s pelvis

68
Q

What term is used to describe the relationship of the presenting part to the 4 parts of the mother’s pelvis?

KNOW THIS!!!!!!

A

Fetal Position

69
Q

Fetal Station

KNOW THIS!!!!!!

A
  • Relationship of fetal part ot imaginary line between the maternal ischial spine

OR

  • Measure of the degree of descent of the presenting part through the birth canal

-5
-4
-3 = Minimum to rupture membranes; risk of prolapsed cort if not at -3
-2
-1
0 (baby is engaged)
+1
+2
+3
+4
+5 (birth is imminent)

70
Q

Engagement

KNOW THIS!!!!!!

A

Presenting part of the baby has passed the true pelvis / is in line with the mother’s ischial spine

  • Station 0 = engaged
71
Q

Effacement

KNOW THIS!!!!!!

A

Thinning & shortening of the cervix

Measured in %

  • when 100%, only thin edge can be palpated
72
Q

Dilation

KNOW THIS!!!!!!

A

Enlargement or widening of the cervical opening

  • measures from less than 1 cm to 10 cm

Full Dilation = 10 cm

73
Q

Primary Powers

KNOW THIS!!!!!!

A

Involuntary contractions that are responsible for effacement & dilation of the cervix, as well as fetal decent

74
Q

Secondary Powers

KNOW THIS!!!!!!

A

Voluntary bearing down efforts by the mother

75
Q

What is bloody show?

A

A small amount of blood at the vagina from ruptured capillaries when the cervix effaces

76
Q

What is the definition of true labor?

A

dilation & effacement of the cervix AND descent of the fetus

77
Q

Stages of Labor

KNOW THIS!!!!!!

A
  • First Stage: onset of regular contractions to full cervical dilation
  • Second Stage: full dilation of cervix to birth of infant
  • Third Stage: birth of infant until delivery of placenta
  • Fourth Stage: delivery of placenta to first 2 hours postpartum
78
Q

Define the first stage of labor

KNOW THIS!!!!!!

A

Onset of regular contractions

to the

full cervical dilation

79
Q

Define the second stage of labor

KNOW THIS!!!!!!

A

Full cervical dilation

to

birth of the infant

80
Q

Define the third stage of labor

KNOW THIS!!!!!!

A

Birth of the infant

to the

delivery of the placenta

81
Q

Define the fourth stage of labor

KNOW THIS!!!!!!

A

Delivery of the placenta

to the

first 2 hours postpartum

82
Q

What is the difference in an ultrasound transducer and a tocotransducer?

KNOW THIS!!!!!

A

**Tocotransducer = ** measures uterine contractions and is placed over uterine fundus

*

Ultrasound Transducer = measures the fetal heart rate (FHR) and is placed over fetal back, BELOW mother’s umbilicus

83
Q

Epidurals

KNOW THIS!!!!

A

Can cause hypotension

  • give fluid bolus of LR 15-30 minutes prior
84
Q

Ultrasound Transducer

**What is the difference in an ultrasound transducer and a tocotransduce

A

Measures Fetal Heart Rate

  • placed on fetal back & below mother’s umbilicus
85
Q

Tocotransducer

KNOW THIS!!!!!

A

Measures uterine contractions

  • placed over uterine fundus
86
Q

Intrauterine pressure catheter (IUPC)

KNOW THIS!!!!!

A

Measures changes in uterine pressure

87
Q

Fetal Scalp Electrode

KNOW THIS!!!!!

A

Measures fetal heart rate

  • invasive procedure since electrode goes into fetus’ head
  • can only be done if membranes are ruptured
88
Q

What is baseline fetal heart rate (FHR)?

KNOW THIS!!!!!

A

Average rate during a 10 minute segment

89
Q

What is the normal range for baseline fetal heart rate (FHR)?

KNOW THIS!!!!!

A

110 - 160 bpm

  • Brady is < 110 bpm
  • Tachy is > 160 bpm
90
Q

What is variability in fetal heart rate?

KNOW THIS!!!!!

A

Irregular waves or fluctuations in the baseline fetal heart rate

91
Q

Describe the 4 categories of baseline fetal heart rate variability

KNOW THIS!!!!!

A

Absent - amlitude range is undetectable
* fetal sleep cycle

Minimal - amplitude range ≤ 5 bpm

Moderate - amplitude range 6-25 bpm

Marked Variability - amplitude range > 25 bpm
* many cases this is likely a normal variant

92
Q

Absent Variability

A

Amplitude range is undetectable

93
Q

Minimal Variability

A

Amplitude range is ≤ 5 bpm

94
Q

Moderate Variability

A

Amplitude range is 6 - 25 bpm

95
Q

Marked Variability

A

Amplitude range is > 25 bpm

96
Q

Baseline Fetal Heart Rate Accelerations

KNOW THIS!!!!!

A

Acceleration to peak is < 30 seconds

*

Peak must be ≥ 15 bpm for at least 15 seconds

Abrupt increase in FHR

97
Q

What are fetal heart rate decelerations?

KNOW THIS!!!!!

A

Decreases in fetal heart rate

  • early
  • late
  • variable
  • prolonged
98
Q

Explain VEAL CHOP!!!!!!

KNOW THIS!!!!!

A
  • Variable decelerations = Cord compression
  • Early decelerations = Head compression
  • Accelerations = Okay
  • Late decelerations = Placental insufficiency / perfusion issues
99
Q

What are early decelerations & what is the cause?

KNOW THIS!!!!!

A

Mirrors contractions

  • CAUSE: Cord compression (V = C in VEAL CHOP)
100
Q

What are late decelerations & what is the cause?

KNOW THIS!!!!!

A

Dip in fetal heart rate AFTER the peak of the contraction

  • CAUSE: Placental insufficiency (L = P in VEAL CHOP)
101
Q

What is the management for abnormal fetal heart rates?

KNOW THIS!!!!!

A

LIONS PIT

*

1.) STOP PITOCIN = FIRST STEP

*

  • Left side lying
  • IV fluid bolus
  • Notify physician
  • 1.) Stop Pitocin
102
Q

Babies have root & suck reflex until what age?

A

4 months

103
Q

Babies have moro reflex until what age?

A

6 months

104
Q

Babies have palmar grasp reflex until what age?

A

4-6 months

105
Q

Babies have plantar grasp reflex until what age?

A

9 months - 1 year

106
Q

Babies have Babinski reflex until what age?

A

1 year

107
Q

Babies have tonic neck / fencing position reflex until what age?

A

4 months

108
Q

Babies have stepping reflex until what age?

A

3-4 months

109
Q

Contraindications for spinal / epidural block

A
  • platelets greater than 100,000
  • HTN
  • Infection
  • coagulopathy
110
Q

What is the treatment for maternal hypotension with decreased placental perfusion after anesthesia?

A
  • Left side
  • IV bolus
  • Displace uterus
  • Elevate legs
  • Vasopressors

OB Final Exam (8 decks)

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