Exam 3 Review

Question 1

What to watch for with magnesium toxicity?

Answer 1

Respirations <12
Deep tendon reflexes <2+
4-7 range
Minimal variability is normal when mom is on magnesium

Question 2

Betamethasone

Answer 2

12mg IM every 24 hours
Helps with fetal lung development

Question 3

What to give mom before an epidural?

Answer 3

LR fluid bolus

Question 4

What is HELLP syndrome?

Answer 4

Hemolysis, Elevated Liver Enzymes, Low platelet
Early: flu-like symptoms
Risk for DIC

Question 5

Placenta Previa Description

Answer 5

Painless, Bright red bleeding
No vaginal exam until ultrasound confirms placement

Question 6

Partial Placenta Rupture

Answer 6

1 Risk factor: HTN

Dark red blood
Firm Abdomen
NO NEED FOR C-SECTION

Question 7

Threatened Abortion

Answer 7

Cervix is not dilating (Can still save baby) <20 weeks

Question 8

Inevitable Abortion

Answer 8

Can’t save baby (Cervix is already opening) <20 weeks

Question 9

How many weeks is a stillbirth?

Answer 9

> 20 weeks

Question 10

Meningitis Vaccine

Answer 10

No vaccine for baby till 11-12 Years old
Droplet precautions

Question 11

Prevnar

Answer 11

Prevents infant pneumonia

Question 12

Ear infection causes more pain when what?

Answer 12

Laying down causes more pressure
Respiratory infection starts to lead to ear infection

Question 13

Meningitis diagnosis?

Answer 13

Spinal tap: Increase WBC and Protein, decrease level of glucose
Can tell you whether it’s viral or bacterial

Question 14

Meningitis treatment?

Answer 14

Anticonvulsants
Viral: treat symptoms
Antibiotics before antipyretics

Question 15

What happens with too much intake of Aspirin?

Answer 15

Reye’s syndrome

Question 16

Gavage feeding

Answer 16

Lay on right side
Chest x-ray
15-30 ml administration 30-60 minutes
Water soluble lubricant
Warm water

Question 17

Lactulose symptoms/diagnostic

Answer 17

Severe diarrhea
Stool acidity/hydrogen breath test/ low glucose 2 hours after test
Don’t delay treatment for kids

Question 18

Late symptoms of increased ICP

Answer 18

Abnormal pupil response
Bradycardia
Abnormal posturing (Decerebrate-worse, arms extended)

Question 19

Early signs of increased ICP

Answer 19

Nausea/vomiting
Lethargy
Seizures
Budging fontanel, increased head circumference

Question 20

Above or below ischial spine?

Answer 20

• Negative above
  + Positive below

Question 21

Braxton Hicks contractions

Answer 21

False contractions

Question 22

Post term baby

Answer 22

Risk for meconium aspiration
Hypoglycemia

Question 23

Cytotec med

Answer 23

Speeds up cervix

Question 24

Tocolytic Therapy

Answer 24

1 purpose: prolong labor to give GLUCOCORTICOIDS_BETAMETHAZONE

Need to have >2cm with regular contractions
Magnesium sulfate IV
Terbutaline sub Q 0.25mg (normal side effects: Palpitations, tachycardia)

Question 25

Magnesium Sulfate

Answer 25

4g loading dose over 30-60 minutes, 1g maintenance, IV
Prevents Cerebral Palsy
Decrease reflexes <2+
Minimal variability normal with Med.

Question 26

Oligohydramnios

Answer 26

Decreased amount of amniotic fluid

Question 27

Magnesium toxicity

Answer 27

DON’T CHANGE MAG INFUSION UNLESS RESPIRATIONS ARE DECREASED (<12 OR DECREASED BY 4)
Give calcium gluconate
Do not give with nifedipine (can cause skeletal muscle blockage)
Monitor urine output/VS (hourly)

Question 28

External Cephalic Version

Answer 28

Process of rotating baby

Question 29

Spontaneous rupture of membrane SROM

Answer 29

Assess color and consistency to identify meconium aspiration

Question 30

Toco meter

Answer 30

Can’t measure intensity (palpate to determine intensity)
Contractions every 2-5 minutes lasting for 45-90 seconds

Question 31

IUPC

Answer 31

Intrauterine pressure catheter
-measures contraction intensity

Question 32

Tachysystole

Answer 32

> 5 contractions in 10 minutes
baby is not getting good oxygen

Question 33

Pre-rupture of membrane

Answer 33

1sr Assessment: fetal Heart Rate
2nd: color and consistency for meconium aspiration

Question 34

Fundal height

Answer 34

Matches cm >20 weeks
Increases height with: Polyhydramnios
Decreases height with: SGA and oligohydramnios

Question 35

shoulder dystocia

Answer 35

1st: Mc Roberts maneuver (knees to chest)
Suprapubic pressure
No forceps/no vaccume

Question 36

Chorioamnionitis

Answer 36

Abdominal tenderness
Headache after having baby: CHECK TEMPERATURE FIRST

Question 37

Which hormone maintains pregnancy?

Answer 37

Progesterone

Question 38

Primary Powers

Answer 38

Effacement
Dilation
Involuntary Contractions

Question 39

Secondary Powers

Answer 39

Contraction changes
Overwhelming urge to push

Question 40

First stage of Labor

Answer 40

Latent: 0-3cm
Active: 4-7cm
Transitional: 8-10cm

Question 41

Difference between false and true labor?

Answer 41

Cervical Dilation
No change in dilation/effacement in 2 hours

Question 42

Stage 2-4 of labor

Answer 42

2: begins with complete cervicale dilation, ends with delivery of baby
3rd: ends when placenta is delivered
4th: Recovery (1-4 hours)

Question 43

Tachycardia is a sign for what for fetus?

Answer 43

Infection

Question 44

ephedrine

Answer 44

Help with epidural side effects (Maternal Hypotension)
ITCHING IS NORMAL

Question 45

6 P’s of vascular injury

Answer 45

Pain
Pallor
Pulselessness
Pressure
Paresthesia
Paralysis

Question 46

Inflammation in eyes, Autoimmune disease

Answer 46

Juvenile Idiopathic Arthritis

Question 47

FHT Category I

Answer 47

Moderate Variability (6-25)
Only have one type of Deceleration “Early”

Question 48

Which is the most common type of Cerebral Palsy

Answer 48

Spastic (Stiff muscles): Tip-toe walking, positive Babinski reflex after 2 years
Treatment: Baclofen Med through intrathecal pump (relaxes muscles)

Question 49

Myelomeningocele

Answer 49

AKA Spina bifida or Racheschisis
Elevated AFP (Alfa Fetal protein)