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Level 3 > Families Exam 1 > Flashcards

Families Exam 1 Flashcards

1
Q

What are some presumptive signs of pregnancy?

A
  • amenorrhea
  • fatigue
  • N/V
  • quickening
  • uterine enlargement
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2
Q

What is Hegar’s sign?

A

softening/compressibility of the lower uterus

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3
Q

What is Chadwick’s sign?

A

blue/purple color of the cervix and vaginal mucosa

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4
Q

What is Goodell’s sign?

A

softening of the cervical tip

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5
Q

What sign of pregnancy is ballottement?

A

Probable

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6
Q

Is a positive pregnancy test a probable or positive sign of pregnancy?

A

Probable

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7
Q

What cardiovascular components INCREASE with pregnancy?

A
  • CO (30-50%)
  • BV (30-45% @ term)
  • HR (10-15/min)
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8
Q

What is striae gravidarum?

A

stretch marks

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9
Q

What is linea nigra?

A

a dark line from the belly to the pubic area

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10
Q

What is chloasma?

A

increased pigmentation on face

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11
Q

What does Naegle’s rule determine? How?

A
  • delivery date
  • take the first day of your last period, subtract 3 months and add 7 days
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12
Q

What is the G in GTPAL?

A

Gravidity: # of pregnancies, including current pregnancy and abortion/miscarriage

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13
Q

What is the T in GTPAL?

A

Term births: 38+ weeks

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14
Q

What is the P in GTPAL?

A

Preterm births: up to 38 weeks

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15
Q

What is the A in GTPAL?

A

Abortion/miscarriage: lost before 20 weeks

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16
Q

What is the L in GTPAL?

A

Living children

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17
Q

What are signs of infection during pregnancy?

A
  • burning on urination
  • diarrhea
  • fever/chills
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18
Q

What are signs of miscarriage or ectopic pregnancy?

A
  • abdominal cramping
  • vaginal bleeding
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19
Q

How can backache be relieved during pregnancy?

A
  • pelvic tilt exercises
  • side-lying position
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20
Q

What side should you lay on if experiencing supine hypotension?

A

left

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21
Q

How can SOB be relieved during pregnancy?

A

extra pillows

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22
Q

How can gingivitis be relieved during pregnancy?

A

brushing teeth gently

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23
Q

How can nasal stuffiness be relieved during pregnancy?

A

use of a humidifier

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24
Q

How can epistaxis be relieved during pregnancy?

A

NS drops/spray

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25
Q

How can varicose veins and edema be relived during pregnancy?

A
  • elevate legs
  • NO restrictive clothing
  • DONT sit/stand too long
  • DONT cross knees
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26
Q

What could a gush of fluid from the vagina mean?

A

ROM

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27
Q

What could decreased fetal movement mean?

A

fetal distress

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28
Q

When is a GBS done?

A

35-37 weeks

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29
Q

What med do you give if the patient is GBS positive?

A

Penicillin G

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30
Q

What could protein in the urine indicate?

A

gestational HTN

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31
Q

What could glucose/ketones in the urine indicate?

A

gestational diabetes

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32
Q

What could WBC’s in the urine indicate?

A

infection/UTI

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33
Q

What does TORCH stand for?

A
  • toxoplasmosis
  • other infections
  • rubella
  • cytomegalovirus
  • herpes
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34
Q

When is a maternal serum alpha-fetoprotein test done? What does it test for?

A
  • between 15-22 weeks
  • down syndrome (low level)
  • neural tube defects (high level)
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35
Q

What should the patient do before an amniocentesis?

A

empty their bladder

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36
Q

What position should the patient be in for an amniocentesis?

A

supine with a wedge under the right hip

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37
Q

What complications can arise from an amniocentesis?

A
  • AF emboli
  • hemorrhage
  • infection
  • PROM
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38
Q

What med promotes fetal lung maturity?

A

betamethasone

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39
Q

When is a glucose tolerance test done?

A

between 24-28 weeks

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40
Q

Why would you do a 3 hour glucose tolerance test?

A

if the 1 hour result was >140

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41
Q

What glucose test do you have to fast for?

A

3 hour

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42
Q

How is gestational diabetes diagnosed?

A

by 2 elevated blood glucose readings from the 3 hour glucose tolerance test

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43
Q

How much weight gain should occur during the first trimester?

A

up to 4.4 pounds

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44
Q

How much weight gain should occur in the second and third trimesters?

A

1 pound/week

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45
Q

How much weight should a normal person gain during pregnancy?

A

25-35 pounds

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46
Q

How much weight should an underweight person gain during pregnancy?

A

28-40 pounds

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47
Q

How much weight should an overweight person gain during pregnancy?

A

15-25 pounds

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48
Q

How much weight should an obese person gain during pregnancy?

A

11-20 pounds

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49
Q

In what trimester should your calories increase by 340?

A

second

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50
Q

In what trimester should your calories increase by 452?

A

third

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51
Q

What should you eat in the morning before getting up if experiencing nausea?

A

crackers or dry toast

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52
Q

How much folic acid should you take a day when pregnant?

A

600 mcg

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53
Q

How much calcium should be taken when pregnant?

A

1000 mg

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54
Q

How should iron supplements be taken?

A

in between meals with vitamin C

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55
Q

What does the BPP assess?

A
  • FHR
  • fetal breathing movements
  • gross body movements
  • fetal tone
  • qualitative amniotic fluid volume
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56
Q

What is an ideal BPP score?

A

8-10

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57
Q

What does an NST assess?

A

FHR response to fetal movement

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58
Q

What position should the patient be in for an NST?

A

reclining chair, semi-fowlers, or left lateral

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59
Q

What should the patient do during an NST?

A

press the button when she feels the baby move (FHR should increase)

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60
Q

What result do you want from an NST?

A
  • reactive
  • moderate variability
  • accelerations (15/min for 15 seconds, 2 times in 20 mins)
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61
Q

What should you do if you receive a nonreactive NST result?

A

CST or BPP

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62
Q

How can you test how the fetus will tolerate labor?

A

a contraction stress test

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63
Q

What is a negative CST result?

A
  • normal finding
  • 3 contractions with NO late decels in a 10 min period
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64
Q

Which type of ultrasound requires a full bladder?

A

transabdominal

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65
Q

What is the biggest risk to the fetus with gestational diabetes?

A

HYPOGLYCEMIA

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66
Q

How is gestational diabetes treated?

A

diet and exercise

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67
Q

Is there treatment for cytomegalovirus?

A

NO

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68
Q

What med should be administered to babies born to a mom with Gonorrhea?

A

erythromycin eye drops

69
Q

What causes the compromise of fetal circulation?

A

placental abruption

70
Q

What term explains gestational HTN with proteinuria?

A

preeclampsia

71
Q

What BP and level of proteinuria show MILD preeclampsia?

A
  • BP 140/90
  • 1+ proteinuria
72
Q

What BP and level of proteinuria show SEVERE preeclampsia?

A
  • BP 160/110
  • 3+ proteinuria
73
Q

What symptom might you see with SEVERE preeclampsia?

A

RUQ abdominal pain

74
Q

What symptoms might you see with preeclampsia?

A
  • severe HA
  • blurry vision
  • face/hand edema
  • weight gain
75
Q

How can you assess for proteinuria?

A

clean catch specimen

76
Q

What med should you give if the systolic BP is >160?

A

labetalol

77
Q

What med can you give for preterm labor?

A

mag sulfate

78
Q

What should you monitor is preterm labor is suspected?

A

FHR and contraction pattern

79
Q

How long should you avoid pregnancy after a spontaneous abortion?

A

2 months

80
Q

Hyperemesis gravidarium can cause metabolic acidosis and metabolic alkalosis. How?

A
  • starvation can cause met. acidosis
  • vomiting can cause met. acidosis
81
Q

What happens the electrolytes with hyperemesis gravidarium?

A

they are low (Na, K, Cl)

82
Q

What happens to HR and BP with hyperemesis gravidarium?

A

HR increases and BP decreases

83
Q

What does HELLP stand for?

A
  • Hemolysis
  • Elevated Liver enzymes
  • Low Platelets
84
Q

What can low platelets result in?

A
  • thrombocytopenia
  • abnormal bleeding/clotting time
  • bleeding gums
  • petechiae
  • DIC
85
Q

What are the symptoms of HELLP syndrome?

A
  • severe continuous HA
  • N/V
  • blurred vision, flashes of lights/dots
  • periorbital/facial/hand/abdominal edema
  • proteinuria
  • jaundice
  • epigastric/RUQ pain
  • seizures
86
Q

What med prevents seizures, suppresses contractions/stops labor, and is used for HTN?

A

mag sulfate

87
Q

What do decreased DTR’s, LOC, UO, and RR show signs of?

A

mag sulfate toxicity

88
Q

What is the antidote for mag sulfate?

A

calcium gluconate/chloride

89
Q

What is the therapeutic range for mag sulfate?

A

5-8

90
Q

When is rhogam given?

A
  • between 24-28 weeks
  • 72 hours after birth
  • after amniocentesis
91
Q

What is terbutaline’s function?

A
  • relaxes smooth muscles
  • inhibits uterine activity
92
Q

What is the fetal lie?

A
  • the baby’s spine in relation to the mom’s spine
93
Q

What are the 3 types of fetal lie?

A
  • longitudinal/parallel: up & down
  • oblique: diagonal
  • transverse: straight across
94
Q

What is fetal attitude?

A

The relationship of fetal parts to one another

95
Q

What do you want the fetal attitude to be?

A

flexed chin

96
Q

What is a negative fetal station?

A
  • above the ischial spine
  • no baby yet
97
Q

What is a positive fetal station?

A
  • below the ischial spine
  • yes baby
98
Q

What is station 0?

A
  • presenting part: baby’s head
  • widest part of the head is level with mom’s ischial spine
99
Q

What are the most favorable and least favorable passageways?

A
  • most: gynaecoid
  • least: platypelloid
100
Q

What causes enlargement/widening of the cervical opening and canal?

A

dilation

101
Q

What causes the shortening/thinning of the cervix?

A

effacement

102
Q

How soon after ROM does labor usually occur?

A

within 24 hours

103
Q

What is the pH of amniotic fluid?

A

7-7.5

104
Q

What should be assessed immediately after ROM?

A

FHR

105
Q

What are the cardinal movements?

A
  1. engagement
  2. descent
  3. flexion
  4. internal rotation
  5. extension
  6. external rotation
  7. birth by expulsion
106
Q

What do Leopold’s maneuvers determine?

A
  • baby’s position
  • position, lie, attitude
107
Q

What is the fetal part that is ideal at the fundus?

A

the butt (should feel soft and squishy)

108
Q

How can you tell if the baby is engaged?

A

it cannot be pushed back up from the lower part of the uterus

109
Q

What is lightening?

A

when the fetal head descends onto the pelvis

110
Q

When does lightening happen, and what does it help with?

A
  • about 14 days before labor
  • makes it easier to breathe
111
Q

How much weight is lost preceding labor?

A

1-3.5 pounds

112
Q

What position does the cervix move to in true labor?

A

anterior

113
Q

How dilated is the patient during the latent phase?

A

0-3 cm

114
Q

What is the duration and frequency of ctx during the latent phase?

A

30-45 seconds for 5-30 mins

115
Q

How dilated is the patient during the active phase?

A

4-7 cm

116
Q

What is the duration and frequency of ctx during the active phase?

A

40-70 seconds for 3-5 mins

117
Q

How dilated is the patient during the transition phase?

A

8-10 cm

118
Q

What is the duration and frequency of ctx during the transition phase?

A

45-90 seconds for 2-3 mins

119
Q

What is the pushing stage of labor?

A

second

120
Q

How frequent are contractions during the second stage of labor, and how long does the stage last?

A

every 1-2 minutes for 30 mins-2 hours

121
Q

What part of the placenta should be delivered first?

A

the surface that was facing the baby and touching amniotic fluid (shiny shultze)

122
Q

How long does the third stage of labor last?

A

5-30 mins

123
Q

How long does the fourth stage of labor last?

A

1-4 hours

124
Q

What is considered a prolonged contraction?

A

> 90 seconds

125
Q

What is considered too frequent of contractions?

A

> 5 in 10 mins

126
Q

What can a bad resting tone lead to?

A

hypoxia and decreased FHR

127
Q

What is effleurage?

A

light, gentle, circular stroking of the patient’s abdomen with the fingertips

128
Q

What is sacral counterpressure?

A

applying pressure to the patient’s sacral area using the heel of the hand or fist to counteract lower back pain

129
Q

When during labor are opioids given?

A

the early part of active labor (labor must be well established - 4 cm dilated, station 0)

130
Q

What is the antidote for opioid toxicity?

A

naloxone

131
Q

How long can opioids be given?

A

NOT after 7 cm dilated

132
Q

When can epidural anesthesia be used during labor?

A

From at least 4 cm dilated until 9.5 cm dilated

133
Q

What eliminates sensation from the belly button to the thighs?

A

epidural anesthesia

134
Q

How should the patient be positioned for epidural anesthesia?

A

with back curved

135
Q

How can you prevent hypotension with an epidural?

A
  • 2 L IV fluid bolus before
  • IV vasopressor
136
Q

What is local anesthesia for the perineum, vulva, and rectal areas?

A

pudendal block

137
Q

When is a pudendal block given?

A

10-20 mins before delivery

138
Q

What is a normal FHR?

A

110-160 bpm

139
Q

Do you want variability in the FHR?

A

yes, moderate (6-25/min)

140
Q

What variability of the FHR is non-reassuring?

A

none, minimal (<5/min) or too much (>25/min)

141
Q

What decelerations of the FHR are non-reassuring?

A

late and variable

142
Q

Are FHR accelerations normal?

A

YES

143
Q

What should you do for a patient having late decels?

A
  • side lying position
  • increase IVF
  • O2
  • prepare for c-section
144
Q

What can cause variable decels?

A

cord compression

145
Q

What can cause early decels?

A

head compression

146
Q

What can cause late decels?

A

placental indufficiency

147
Q

What medication should you give for hypotonic ctx?

A

oxytocin

148
Q

What medication should you give for hypertonic contractions?

A

mag sulfate

149
Q

What does the bishop score have to be for induction of labor?

A

> 8 for multiparous, >10 for nulliparous

150
Q

What is rated for the bishop score?

A
  • dilation
  • effacement
  • consistency
  • position
  • station
151
Q

What should you watch for with pitocin/oxytocin?

A

uterine hyperstimulation

152
Q

How is oxytocin given?

A

on a pump using the most central IV port

153
Q

If the patient reports feeling something coming through her vagina, what could this be?

A

the umbilical cord

154
Q

How can severe fetal hypoxia possibly be identified?

A

excessive fetal activity and then no fetal activity

155
Q

What position should the patient be in if prolapsed cord is suspected?

A

knees to chest

156
Q

How should you keep the visible umbilical cord from drying out?

A

a warm, sterile, saline-soaked towel

157
Q

What is McRoberts maneuver?

A

bringing the mom’s thighs close to the chest to help with shoulder dystocia

158
Q

Why should panting be encouraged during precipitous labor?

A

it controls the urge to push

159
Q

What characterizes fetal bradycardia?

A

FHR <110/min for 10 mins or more

160
Q

What should you do to oxytocin in the event of fetal bradycardia?

A

DISCONTINUE

161
Q

What characterizes fetal tachycardia?

A

FHR is >160/min for 10 mins or more

162
Q

Most commonly, what color is meconium-stained amniotic fluid?

A

green

163
Q

What L/S ratio indicates fetal lung maturity?

A

2:1

164
Q

What does the absence of PG indicate?

A

respiratory distress

165
Q

What ctx frequency is associated with uterine hyper stimulation?

A

> q 2 mins

166
Q

What ctx duration is associated with uterine hyperstimulation?

A

> 90 seconds

167
Q

What ctx intensity pressure is associated with uterine hyperstimulation?

A

> 90 mmHg

168
Q

What uterine resting tone is associated with uterine hyperstimulation?

A

> 20 mmHg between ctx

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