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OB exam 3 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

what is the best plan of care for an ectopic pregnancy?

A

methotrexate less than 8 weeks

salpingectomy to remove part of the tube

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2
Q

what are the adverse effects of mag sulfate

A 
respiratory depression
low BP
uterine bogginess in postpartum
absent DTR's
decreased urine output
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3
Q

what are the expected outcomes of mag sulfate?

A

therapeutic range 4-7
decreased BP
relaxed smooth muscle

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4
Q

explain the warning signs you may see with a pt with cerclage

A

discharge

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5
Q

complications of incomplete abortions

A

sepsis (profuse bleeding, cramping, fever, chills)

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6
Q

potential complications of placenta previa?

A

bleeding and hemorrhade

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7
Q

contraindications with a placenta previa?

A

hypotension, tachycardia are signs for bleeding

Trendelenburg and oxygen

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8
Q

important labs associated with pre-eclampsia and HELLP

A

elevated liver enzymes

low platelets

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9
Q

most concerning symptoms of pre-eclampsia

A

swelling of face and hands

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10
Q

CST

A 
contraction stress test
stimulate contractions with oxytocin over 10 min to look at FHR
Positive = BAD
for late decelerations do UNCOIL
done for abnormal Biophysical profile
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11
Q

plan of discharge for a 28 wk pregnant patient with pre-eclampsia

A 
no ace inhibitors
monitor bp
measure I&O
kick counts
edema
diet control ( increase protein, low sodium)
NO fluid restriction
bedrest
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12
Q

how do you know if mag sulfate is effective?

A

no seizures, monitor DTR’s (2+, 0 Clonus is normal), serum levels therapeutic 4-7, no pulmonary edema

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13
Q

nursing interventions for patients with pre-eclampsia

A

anti-hypertensive meds
minimize environmental stimulation
seizure precautions

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14
Q

inevitable abortions

A

dilated cervix without passage of tissue, first 20 weeks, no bleeding manage symptoms, if bleeding d&c

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15
Q

incomplete abortions

A

open cervix with tissue in cervix, heavy and profuse bleeding, maybe D&C, suction or cytotec
risk of sepsis

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16
Q

important interventions for preterm pregnancies with placenta previa

A

2 doses of betamethasone

no pelvic exams and complete pelvic rest

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17
Q

signs and symptoms of molar pregnancy

A

dark red vaginal bleeding
increased fundal height
hyperemesis
preeclampsia prior to 20 weeks

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18
Q

what’s included in a biophysical profile

A

US measurement of amniotic fluid, fetal movements, fetal tone, NST, and fetal breathing movements

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19
Q

MSAFP

A

screens for opening of neural tube
occurs 15-20 weeks
low MSAFP = trisomy
Does not screen for turners or kleinfelters

20
Q

what symptoms are associated with concealed placental abruption?

A

increased fundal height
board like, rigid uterine atony
painful

21
Q

symptoms of mag toxicity

A

BLURR( low BP, decreased LOC, Decreased urine output, Low RR, Decreased DTR)
TURN OFF THE MAG

22
Q

diagnostic tests available for genetic testing in pregnancy

A

amniocentesis
chorionic vili sampling
if abnormal quad screening at 18 weeks, nuchal scan test ultrasound

23
Q

what labs test to see if woman is ovulating?

A

progesterone

24
Q

contraceptive efficacy best to least?

A 
nexplanon
male sterilzation
mirena IUD (skyla, Kyla)
female sterilization
paraguard IUD
depro provera
estrogen pills, patches, and rings
25
Q

interventions of hypoglycemia in labor

A

if on insulin drip and hypoglycemic stop the insulin

26
Q

what’s important about 1 hour glucose test

A

no fasting
130-140 elevated and requires 3 hours test
SCREENING

27
Q

what’s important about 3 hour glucose test

A

3 days unrestricted diet and exercise
FASTING after midnight night before
DIAGNOSTIC
avoid caffeine and tobacco 12 hours prior

28
Q

type of birth control NOT recommended for breast feeding

A

anything with estrogen

xulane, nuvaring, orala, anovera, twirla, pills

29
Q

ways you can tell a woman is ovulating

A

regular predictable periods
cramping
dysmenorrhea
spinbarcet mucous (egg white, cloudy, scant)

30
Q

ACHES (CHC)

A 
abdominal pain
chest pain/shortness of breath
severe headache
eye pain, visual disturbances
severe leg pain
31
Q

PAINS (IUD)

A 
period late, pregnant, abnormal bleeding
abdominal pain with intercourse
infection, abnormal discharge
not feeling well, fever, chills, malaise
string missing, short, long
32
Q

contraindications for CHC

A

migraine with aura
clotting disorders
smoking
HTN

33
Q

pathophysiology of GDM

A

glucose crosses placenta not insulin

pregnancy with pre-existing DM the placenta is the problem

34
Q

emergency contaception

A

paraguard- up to 5 days after
ella- 5 days after
plan b- 3 days after

35
Q

hyperglycemia in 1st trimester can cause

A

congenital malformations especially CVD and CNS anomalies

36
Q

causes of poor quality sperm

A 
age
obesity
hot testicles
sti
exposure to radiation/toxins
anti-sperm antibodies
37
Q

low sperm count

A 
hypospadias
undescended testicles  
variceal
decreased testosterone
substances, tobacco, anabolic steroids
38
Q

maternal glucose

A

before meals 60-105
one hour after < 140
two hours after 120
2-6am- 60

39
Q

what is the main reason for treating opiate usage in pregnancy

A

to prevent intrauterine seizures during withdraw

40
Q

clomid

A

stimulates GnRH, binds to estrogen

41
Q

perginol

A

stimulates ovulation, has FSH/LH

42
Q

priority intervention with postpartum psychosis

A

never leave mom alone with baby
medical emergency/ hospitalization
supervise mom with baby

43
Q

complications for hyperemesis gravidarum- mom

A

esophageal rupture
pneumomediastinum
vitamin k and thiamine deficiencies

44
Q

complications of hyperemesis gravidarum- fetus

A

SGA
prematurity
low birth weight

45
Q

labs for hyperemesis gravidarum

A 
ua
cbc
electrolytes
LFT's
bilirubin
thyroid
46
Q

important education points for GDM postpartum

A

most likely to resolve after delivery of infant

likely to have in subsequent pregnancies

OB exam 3 (1 decks)

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