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OB > new exam 2 > Flashcards

new exam 2 Flashcards

1
Q

what defines preterm

A

after 20 weeks and before 37 weeks

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2
Q

biggest risk factor for preterm birth is

A

prior pre term labor

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3
Q

preterm labor criteria

A

UC >6 an hour AND ROM or cervical changes

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4
Q

what does a negative fetal fibronectin mean

A

woman will not deliver within 7-14 days

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5
Q

goal of preterm labor

A

delay birth until corticosteroids (betamethasone) have 72 hours or more to develop fetal lungs

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6
Q

role of magnesium sulfate

A

smooth muscle relaxant

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7
Q

5 risks factors of women to get gestational diabetes

A

women over age 35,
obesity,
family history,
non-Caucasian,
personal hx of gestational diabetes

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8
Q

screening and diagnosing gest. diabetes

A

1hr GTT - if <135 needs 3 hr
3 hr GTT - 2 or more abnormal values means Diagnosed

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9
Q

treating gestational diabetes

A

diet and exercise glycemic control

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10
Q

when does need for insulin increase in preg

A

2nd or 3rd tri

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11
Q

HTN is defined as

A

140/90

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12
Q

chornic HTN defined as

A

preexisiting before 20 weeks

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13
Q

gest HTN defined as

A

after 20 weeks NO proteinuria

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14
Q

preelcampsia defined as

A

systemic disease with HTN and PROTEINURIA AND EDEMA after 20 weeks

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15
Q

eclampsia defined as

A

convulsive state of preelcmapsia

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16
Q

what to give when eclampsia and what to monitor

A

Mg sulfate - RR and DTR

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17
Q

4 risk factors for preeclampsia

A

Primigravida

Hx of personal or
family member
with pre-eclampsia

Paternal Hx (partner previously fathered a pre-eclamptic pregnancy in another woman)

Multiple gestation

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18
Q

6 s.s of preelcampsia

A

Headache
Visual changes
Proteinuria (1+ or greater)
Nausea
Epigastric pain or upper right quadrant pain
Edema (quick onset- face/hands/feet)

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19
Q

labs with preelclampsia

A

Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP)
+ elevated BUN, Cr, uric acid

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20
Q

placenta previa vs placental abruption

A

previa: painless bright red bleeding

tx: C section, NO VAGINAL EXAMS

abruption: SEVERE pain, dark red bleeding, shock (this means lots of blood loss)

tx: energent C section, NO VAGINAL EXAMS

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21
Q

hyperemesis gravidarum tx 5

A

replace f/e with fluids, antiemetics,
accupressure,
ginger/mint,
emotional support

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22
Q

what is ectopic pregnancy

A

implantation into ampulla of fallopian tube

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23
Q

ectopic preg teaching

A

avoid preg for 3 months

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24
Q

teaching for gestational trophoblastic disease

A

avoid pregnancy for 1 year

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25
Q

tx of incompetent cervix

A

ultrasound to monitor for cervical length and cerclage

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26
Q

major risk of ROM

A

chorioemnionitis

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27
Q

heart disease and preg connection

A

sometimes heart disease isnt diagnosed until preg due to cardiac adaptations

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28
Q

7 fetal complications of multiple gestations

A

Premature birth
Lower Birth Weight
IUGR and discordant growth
placental abnormalities
HTN disorders
gest DM
anemia

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29
Q

7 ss of iron def anemia

A

fatigue
weakness
malaise
pallor
tachycardiac
infection risk
preterm labor risk

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30
Q

3 tx for management of iron def anemia

A

vitamin C
stool softeners /fiber
high iron foods

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31
Q

if somone with anemia has leg pain why is it most concernign

A

bc of vasoocclusive crisis

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32
Q

worse complications of sickle cell crisis

A

leg pain/red calf and inflammed

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33
Q

2 teaching for HIV

A

can still have a vaginal birth
no breastfeeding

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34
Q

what if someone with HIV says they have to have a c section

A

its not true

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35
Q

what if mom has rubella or varicells

A

vaccinate after birth

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36
Q

what if mom has herpes

A

need c section if active infection

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37
Q

what to do if mom has hep B

A

newborns recieve HBV and HPV vaccine

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38
Q

parovirus education

A

transmitted in daycare settings

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39
Q

complications of gonorrhe

A

opthalmia - blindness

40
Q

what if mom has group B strep

A

antibiotics during labor

41
Q

3 results of substance abuse in preg

A

preterm
placental issues
vasoconstriction

42
Q

what stimulates labor

A

oxytocin stimulates contraction of smooth muscle

43
Q

5 risks of preterm birth

A

lung immaturity (and resulting respiratory complications), difficulties with temperature and blood sugar regulation, decreased resistance to infection, other immature organ systems, intracranial bleeding.

44
Q

3 risks of postdates birth

A

placenta insufficiency (decreased oxygen to baby, decrease amniotic fluid), fetal “wasting”, fetal death

45
Q

duration and normal

A

start of contraction to end
45-60 seconds

46
Q

frequency and normal

A

Timed from the beginning of one to the beginning of the next.

“q3-4min”

47
Q

what does station 0 mean

A

midpelvis at ischial spine - narrowest diameter

48
Q

what is station

A

Relationship of ischial spines to presenting part of fetus

49
Q

what is estrogen and relaxin role

A

soften cartilage in pelvic joints and increase elasticity of ligaments

50
Q

fetal attitude

A

Relationship of fetal body parts to one another

51
Q

fetal lie + ideal

A

Relation of the mother’s spine to the fetus’s spine + longitudinal

52
Q

what position should baby be in

A

anterior occipit

53
Q

semirecumbent advantage

A

Reduce likelihood of supine hypotension

54
Q

lateral position advantage

A

Removes pressure from the back

55
Q

what position to get in if fetus is posterior

A

hands and knees

56
Q

5 ss of impending labor

A

lightening
braxton hicks
cervical ripening
nesting
bloody show

57
Q

6 features of real labor

A

Occur at regular intervals

Increase in frequency over time

Become stronger over time

Cause the cervix to dilate

Do not stop with change in activity

“5-1-1” Rule (every 5 minutes, lasting 60 seconds, and have been this way for 1 hour)

58
Q

2 assessments for ROM

A

fetal HR and meconium (color, amt, odor)

59
Q

1st stage of labor - latent phase length

A

1-24 hours / 0-3cm

60
Q

active phase of 1st stage of labor

A

3-7cm / 1-12 hours

61
Q

transition phase 1st stage of labor

A

1-3 hours / 7-10cm

62
Q

when should monitoring increase in labor

A

2nd stage

63
Q

nursing actions in 1st stage of labor 3

A

hydration
void every 2 hours
assess HR

64
Q

how long should active phase of 2nd stage of labor last

A

5min to 3 hours

65
Q

time of rest between contractions

A

every 2-3 minutes lasting 60-90 seconds

66
Q

what is important in 3rd stage of labor

A

placental assessment

67
Q

12 non pharm labor discomfort actions

A

Childbirth preparation
Relaxation and breathing techniques
Massage and effleurage, counter-pressure
Heat & cold
Hydrotherapy
Acupressure
Attention focusing and imagery
Ambulation and position changes
Continuous labor support
TENS unit
Sterile water papules (intradermal water block)
Music

68
Q

what to avoid within 1st hour of birth

A

opioids

69
Q

when is epidural given

A

when labor is establushed - during 1st stage in active phase

70
Q

5 actions for epidural

A

fluid bolus
VS of mom and fetus q 5 min for 15
change positions often
urinary retention (may need cath)
monitor for hypotension

71
Q

how to assess strength of uterine contraction

A

IUPC

72
Q

category 1 FHR

A

Baseline HR: 130
Variability: Moderate
Decelerations: Early (no late or variable)
Accelerations: 1-2 lasting <2 minutes

73
Q

normal uterine activity

A

every 3-5 min

74
Q

tx for cord compression

A

change positions

75
Q

tx for cord prolapse

A

lift up on cord until baby is out

76
Q

4 actions for fetal distress

A

reposition
O2
fluids
decrease ptosin

77
Q

IUPC measures

A

uterine contraction frequency, duration and intensity

78
Q

what is fetal acceleration

A

Peak of the acceleration is >15 bpm over the baseline FHR for > 15 sec and < 2 min

79
Q

VEAL CHOP

A
80
Q

what is most common reason for cbirth

A

dystocia

81
Q

hyper vs hypotonic uterine dysfunction

A

Hypertonic uterine dysfunction – frequent and painful UC’s yet uncoordinated with little cervical change and inadequate uterine relaxation

Hypotonic uterine dysfunction - strength of UC is too weak and is insufficient to promote cervical effacement or dilation

82
Q

Fetus moves through the maternal pelvis best

A

with head down and flexed in the occiput anterior position

83
Q

CPD what is it and what to do

A

size, shape, or position of the fetal head prevents passage through maternal pelvis.

prepare for c section

84
Q

primary complication of oxytocin induction

A

uterine tachysystole
“hyperstimulation” - >5 UC’s in 10 minutes

85
Q

nursing action for hyperstimulation UC caused by induction

A

assess HR
and then dec oxytocin

86
Q

4 maternal risks of postterm and when is postterm

A

after 42 weeks

Dystocia of labor
Birth trauma
Postpartum hemorrhage
Potential infection

87
Q

2 contraindication for VBAC/TOLAC

A

no inductions
if more than 1 c section previous = no VBAC

88
Q

what to do if shoulder dystocia

A

mcroberts

89
Q

4 issues of c births

A

increased time in hospital,
longer physical recovery,
increased pain,
emotional issues

90
Q

What is the difference between preeclampsia and gestational hypertension?

A

Pre-eclampsia is a systemic disease causing proteinuria

91
Q

what is placenta acreta

A

when placenta is retained and heavy bleeding

92
Q

4 times vaginal birth cant happen

A

active herpes
placenta previa
breech
prolapsed cord

93
Q

3 things to monitor with FHR

A

Baseline HR
Baseline Variability
Periodic/Episodic Baseline changes

94
Q

when is emotional support most important in labor

A

transition of stage 1

95
Q

biggest risk for VBAC

A

uterine rupture

OB (5 decks)

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