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Maternity > High Risk PowerPoints (Week 7) > Flashcards

High Risk PowerPoints (Week 7) Flashcards

1
Q

biophysical risk factos

A

originates with mother or fetus
may affect development and functioning of both
genetic disorders, nutritional and general health status, and medical or obstetric related illness

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2
Q

kick count that needs to seek help

A

less than 3 / hr

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3
Q

crown rump length

A

crown to sacram

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4
Q

what is the most valuable diagnostic tool used in OB

A

US

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5
Q

BPP

A

physical exam of fetus, US, fluid and body/breathing tone, HR

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6
Q

good BPP scoer

A

greater than 8

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7
Q

modified BPP

A

non stress test and amniotic fluid volume

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8
Q

US look at

A

placenta, fetus, and amniotic fluid

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9
Q

oligo amniotic fluid

A

1-2cm
not much

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10
Q

poly amniotic fluid

A

over distended
>8com

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11
Q

amniocentesis

A

after 15 weeks
evaluate genetics = neural tube defects

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12
Q

moms who are Rh- need

A

rofolac

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13
Q

chorionic villus sampling

A

placental biopsy

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14
Q

maternal assay

A

multiple marker screen
- not diagnosis

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15
Q

first line of fetal testing

A

kick count

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16
Q

what do we want for nonstress test

A

no deceleration
look for variability
acceleration: 15/15, 10/10

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17
Q

gestational HTN

A

onset HTN without other findings after 20 weeks

BP >140/90 resolves after giving birth

can develop chronic HTN

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18
Q

preeclampsia

A

HTN Proteinuria
develops after 20 weeks
can also develop in PP

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19
Q

preeclampsia
- in absence of proteinuria

A

thrombocytopenia
impaired liver funciton
new onset renal insuff
pulmonary edema
new onset cerebral or visual disturbances

The little rabbit poked carrots violently

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20
Q

BP for severe preeclampsia

A

160/110

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21
Q

eclampsia

A

onset of seizure activity/coma in women with preeclampsia
can develop in PP

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22
Q

chronic HTN

A

HTN present before preg or before 20 weeks

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23
Q

preeclampsia common risk factor

A

multifetal gestation, HX of preeclampsia, chronic HTN, preexisting diabetes and/or thrombophilias, paternal factors

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24
Q

cause of preeclampsia

A

unknown
placental

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25
Q

preeclampsia
- increased endothelial cell perm

A

water/prtoein leaking out = edema

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26
Q

preeclampsia
- reduced kidney perfusion

A

decrease UO

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27
Q

preeclampsia
- decreased liver perfusion

A

epigastric pain = RUQ pain

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28
Q

preeclampsia
- neurological complicatpms

A

check DTR, HA

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29
Q

HELLP syndrome

A

hemolysis
elevated liver
low plateleth

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30
Q

how to diagnose protein uric

A

24hr urine is best

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31
Q

what might help prevent preeclampsia

A

low dose aspirin

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32
Q

when to go to ER

A

abdominal pain, significant headache, vaginal spotting, decrease fetal movement

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33
Q

common SE of mag

A

flushed
warm
burning at IV site
diaphoretic

34
Q

therapeutic mag

A

4-7

35
Q

medication choies for preventing/treating seizure activity

A

mag

36
Q

how is mag given

A

IVPB

37
Q

is mag good for BP

A

no it is neuroprotective

38
Q

BP meds

A

Procardia
hydrazine
labetalol

39
Q

loading dose of BP

A

4-6g 15-30min

40
Q

continue maintenance dose

A

1-2g / hr

41
Q

reversal of mag

A

ca gluconate

42
Q

s/s of mag tox

A

lethargic
decrease RR
no DTR

43
Q

mag tox what is the priority

A

turn off mag

44
Q

seizure care

A

don’t put anything in mouth
note time and symptoms

45
Q

PPH priority

A

fundus

46
Q

risk of miscarriage

A

pregnancy ends in result of natural cause before fetal viability

47
Q

miscarriage

A

pregnancy ends as result of natural casuse before fetal viability

48
Q

beta in miscarriage

A

go down

49
Q

miscarriage meds

A

oxytocin to prevent hemorrhage
IM methrogen/hemobate
rh-

50
Q

if there is fever or foul smell

A

call dr

51
Q

cervical insuff

A

passive and painless dilation of the cervix during 2nd tri

52
Q

diagnosis of cervical insufficient

A

measurement of vertical length

53
Q

tx of cervical insuff

A

cerclage

54
Q

cerclage

A

suture is placed around the cervix beneath the mucosa to constrict the internal os of cervix

55
Q

cerclage 12-14

A

profilaxis

56
Q

cerclage 14-23

A

rescue

57
Q

when is a cerclage removed

A

36

58
Q

ectopic preg

A

the fertilized ovum is implanted outside the uterine cavity

59
Q

what is the leading cause of infertility

A

ectopic pregnancy

60
Q

t/f uterus is the only organ capable of containing and sustain a pregnancy

A

true

61
Q

ectopic preg 3 Classic symptoms

A

abdominal pain
delayed menese
abnormal vaginal bleeding
dull lower quad pain
referred pain to the shoulder

62
Q

beta in ectopic

A

high

63
Q

US in ectopic

A

nothing

64
Q

ruptured ectopic

A

OR

65
Q

non ruptured ectopic

A

methotrexate
- chemo drug
destroys rapidly dividing cells

66
Q

for ectopic we should avoid meds stronger than

A

Tylenol we do not want to mask s/s of rupture

67
Q

molar preg

A

trophoblastic disease
no placenta
no embryonic or fetal parts

68
Q

placental previa

A

painless bright red vaginal bleeding
abdominal examination usually reveals a soft, relaxed, nontender uterus and normal tone

69
Q

placental previa

A

placenta is over the internal os

70
Q

placental preja vag exam

A

no

71
Q

placental abruption

A

detachment of part or all of the placental form implantation site after 20 weeks gestation

72
Q

placental abruption

A

vag bleeding, abdominal pain, uterine tenderness, contractions, board line admen

73
Q

can abruption always able to tell on US

A

no
50%

74
Q

velamentous insertion of the cord

A

cord vessels branch at membranes and then into the placenta

umbilical cord does not attach to the placenta correctly

75
Q

glucose crosses
insulin crocess

A

glucose does insulin docent

76
Q

dm not in good control

A

increase risk for miscarriage

77
Q

preconception counseling

A

tight glycemic control

78
Q

does the insulin regimen change frequently

A

yes

79
Q

t/f first 24 hours insulin requirements drop substinally

A

yes

80
Q

hyperemesis gravidarum

A

so much vomiting there is wt loss, electrolyte imbalance, nutritional def, ketonuria

81
Q

hyperemesis gravidarum tx

A

B6 and doxalamine

Maternity (25 decks)

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