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OBGYN > Exam 2 SG Material > Flashcards

Exam 2 SG Material Flashcards

1
Q

What should you do first if a patient has a heavily saturated pad?

A

Change pad, apply new pad, and reassess (don’t assume that patient is hemorrhaging)

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2
Q

What is the normal QBC of vaginal delivery? for C-section?

A

Vaginal: 500 mL or less
Delivery: 1,000 mL or less

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3
Q

Maternal mortality is defined as?

A

Death from complications of pregnancy/childbirth up to 1 year after birth

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4
Q

What are 3 goals for prevention of maternal mortality listed in Healthy People 2021?

A
  1. Reducing adolescent pregnancy (eg: use of birth control)
  2. Reducing maternal mortality rate
  3. Reducing infant mortality rate
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5
Q

What is uterine involution?

A

Uterus returning back to pre-pregnancy size

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6
Q

By what day should the uterus NOT be palpable?

A

Day 10 after delivery

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7
Q

If the uterus is shifted to one side during fundus assessment, what should the nurse do?

A

Encourage mom to void (shifted uterus indicates bladder distention)

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8
Q

What is the purpose of applying pressure to the lower uterine segment while palpating the fundus?

A

To prevent uterine inversion

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9
Q

Endometrial healing is assessed by?

A

Assessing lochia (color, amount, odor)

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10
Q

Perineum is assessed every shift using the acronym REEDA which stands for:

A

Redness, Edema, Ecchymosis, Discharge, Approximation of edges of episiotomy or laceration

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11
Q

What are the 4 degrees of laceration?

A

1st: vaginal mucous membranes and the perineal skin
2nd: vaginal mucous membranes, perineal skin, and the fascia of the perineal body
3rd: perineal skin, vaginal mucous membranes, rectal sphincter
4th: perineal skin and fascia, vaginal mucous membranes, rectal sphincter, and the rectal mucosa and lumen

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12
Q

What is a midline episiotomy?

A

Incision that is midline on the perineum; heal more quickly and cause less pain then a mediolateral episiotomy

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13
Q

What is a mediolateral episiotomy?

A

Incision that is made at a 45-degree angle to the perineum

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14
Q

Patient education for non-breastfeeding women? (3)

A
  • Wear a supportive bra 24 hrs a day
  • Ice packs to breast/cold showers
  • Avoid expressing or stimulating the breast avoiding heat
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15
Q

What is the #1 cause of postpartum hemorrhage?

A

Uterine atony

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16
Q

Blood loss is indicated by which s/s?

A

High HR, Low BP

17
Q

Women are at risk for orthostatic hypotension during the first postpartum week when standing from a seated or prone position. Interventions include:

A
  • Instructing the woman to rise slowly to a standing position
  • Assisting the woman when ambulating during the first 24 hrs postbirth
  • Help the woman when sitting if she becomes dizzy or faint
18
Q

Postpartum assessments/interventions: (2)

A
  • Apply compression stockings to prevent DVT

- Assess for infection: temperature changes, chills, tachycardia (fever: >38 C)

19
Q

What is a hematoma?

A

Blood pocket in the vaginal area after a vaginal delivery; very painful; changes in BP and HR

20
Q

Women who are receiving oxytocin or tocolytics (eg: magnesium sulfate or terbutaline) are at risk for?

A

Pulmonary edema (fluid retention)

21
Q

How often should the nurse assess respirations postpartum?

A

Every 15 mins for the first hour, every 30 mins for the second hour, every 4 hrs for the next 22 hrs, every shift after the first 24 hrs

22
Q

What is the normal respiration rate and oxygen saturation for women postpartum?

A

12-20 bpm; 95% or higher

23
Q

Rhogam injection is given at ___ weeks for MOTHERS with a blood type of ____.

A

28 weeks; negative blood type

24
Q

What will the mother receive if the baby is delivered and has a Rh (+) blood type?

A

Mother gets a second dose of Rhogam before discharge (alleviates all antibodies for second or third pregnancy)

25
Q

What if the baby is delivered and has a Rh(-) blood type?

A

Mother does not need a second dose of Rhogam

26
Q

When is the only time that an Rh(-) mom will NOT need a Rhogam injection?

A

If the DAD is Rh (-) because Rh (-) is a recessive gene, so the baby will definitely be Rh (-)

27
Q

Postpartum vaccinations include (4)

A
  • Tdap (tetanus, diptheria, and pertussis)
  • Hep B
  • Varicella
  • Influenza
28
Q

How much is a woman expected to void postbirth?

A

300 cc within 2 to 4 hours after delivery

29
Q

Early voiding decreases the risk of?

A
  • cystitis

- prevents bladder distension which could lead to uterine atony and postpartum hemorrhage

30
Q

Cystitis

A
  • bladder inflammation/infection
  • s/s: frequency, urgency, pain/burning on urination
  • tx: antibiotic therapy, increased hydration, rest
31
Q

Changes in the endocrine system are indicated in changes in hormones after delivery of the placenta; including:
estrogen, progesterone, prolactin. Which increase and decrease?

A

Estrogen: levels begin to rise after the first week postpartum
Progesterone: decrease
Prolactin: increases in women who are lactating; decrease for nonlactating women

32
Q

Diaphoresis is expected in the first few postpartum weeks in response to decreased ____ levels. Profuse sweating assists the body in excreting the _____.

A

Estrogen; increased fluid accumulated during pregnancy

33
Q

Pertaining to the muscular system, the nurse should assess for: (4)

A
  • Diastasis recti abdominis: can feel the separation of the rectus muscle when assessing the fundus; normal and will diminish over time
  • Decreased nerve sensation for women who received an epidural during labor with full sensation returning within a few hours postbirth
  • Headache: associated with preeclampsia or spinal or epidural anesthesia
  • Fatigue: common complaint during postpartum
34
Q

Direutics such as collaise to avoid pushing can help prevent?

A

Postpartum hemorrhage

35
Q

Expectation in GI system in postpartum women? (2)

A
  • appetite increases

- weight loss

36
Q

Teach lactating women who are breastfeeding to increase caloric intake by ___ to ___ calories a day

A

500-1,000 calories a day

37
Q

Guidelines recommend that all women attend a postpartum follow up visit ____ weeks after birth

A

4-6 weeks

38
Q

Assessment used to screen for postpartum depression

A

Edinburgh Postnatal Depression Scale

OBGYN (2 decks)

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