NYP high yield Flashcards
how often do you need a progress note if in early labor / on miso?
q 4 hours
how often do you need a progress note if in active labor / on pitocin?
q 2 hours
how to eval for proteinuria?
P:C >/= 0.3
24 hr urine >/= 300
severe features of PEC
- platelets < 100
- AST/ALT > 2x ULN
- severe / persistent RUQ pain
- creatinine > 1.1
- pulm edema
- new onset HA
when do you need to order PP heparin?
always CS, vaginally if active smoker, BMI > 40, age > 40
who should be rounded on PP?
all CS, complicated vaginal, all DOCA
c-section meds
- bicitra 30 mL PO once
- tylneol 975 mg PO once
- (anes) ancef 2 g IV pre-op
mag dosing for fetal neuro development
6 mg (if < 32 wks)
mag dosing for PEC / seizure ppx
loading dose 4 mg
maintenance dose 2 mg x 2
cardinal movements of labor
engagement, descent, flexion, internal rotation, extension, external rotation, expulsion
cat I tracing
baseline 110-160
mod variability
no late or variable
+/- early / accels
cat III tracing
absent variability + recurrent late OR recurrent variables OR brady
sinusoidal
gestational thrombocytopenia
platelets < 150
1st trimester weeks
1-12
2nd trimester weeks
13-27
3rd trimester weeks
28-40
delivery timing for PEC w/ SF’s before viability
after maternal stabilization
delivery timing for unstable / complicated PEC w/ SF’s (including superimposed / HELLP)
after maternal stabilization
delivery timing for gHTN w/ severe range BP’s
34 wks
delivery timing for stable PEC w/ SF’s
34 wks
delivery timing for difficult to control cHTN with frequent med adjustments
36 wks
delivery timing for cHTN controlled on meds
37 wks
delivery timing for gHTN w/o severe range BP’s
37 wks
delivery timing for PEC w/o SF’s (including superimposed PEC w/o SF’s)
37 wks
delivery timing for cHTN controlled without meds / with lifestyle change
38 wks
superimposed PEC
worsening HTN / proteinuria with prior HTN, asymptomatic with normal labs
when is rhogam given?
type negative at 28 weeks, bleeding / trauma, PP if baby type positive
how long until arrest of dilation
ruptured membranes, 6 hours active labor without cervical change OR 4 hours with ‘adequate’ contractions
what is an adequate contraction
180-200 MVU q 10 min
(measured via IUPC)
what is considered a failed induction
persistence of latent labor after 24 hrs pit / 12-24 hrs ruptured and no cervical change
AMA age for “elective” but well supported timing for induction at 39 wks
35-39 yo
AMA age for medically recommended induction at 39 weeks
40+ yo
c/i’s to cook balloon
ruptured membranes, polyhydramnios, multifetal gestation
at what size (g) is CS recommended for suspected LGA in a mom WITH DM
4500 g
at what size (g) is CS recommended for suspected LGA in a mom WITHOUT DM
5000 g
PP mag dosing for PEC
4 mg loading
2 mg maintenance
gestational age that nifedipine is used for tocolysis
> 32w0d and </= 34w0d
when are tocolytics discontinued for PTL
48 hrs after 1st dose of ACS
nifedipine tocolytic dosing
20 mg PO loading
10 mg q 4-6 hrs prn
fibrinogen levels indicating placental abruption
</= 200
fibrinogen levels indicating absence of placental abruption
> /= 400
weeks considered PPROM
< 34w0d
latency abx
- azithro 1 g PO x 1 dose
- ampicillin 2 g IV q 6 hrs x 48 hrs
- amoxicillin 875 mg PO q 12 hrs x 5 days
OR amoxicillin 500 mg PO q 8 hrs x 5 days
dose of ACS (betamethasone)
12 mg IM x 2 doses q 24 hrs
when is mag used for fetal neuro protection
< 32 wks
oligo MVP
< 2x2
oligo AFI
< 5
pitocin dosing
start at 2 mu/min
increase by 2 mu/min q 30 min
max 40 mu/min
goal: cxs q 2 min
pitocin dosing if TOLAC
start at 1 mu/min
increase by 1 mu/min q 30 min
PV miso dosing
25 micro g q 4 hrs x 3 doses
how long after PV miso can you start pit
4 hrs
PO miso dosing
25 micro g q 2 hrs x 6 doses
how long after PO miso can you start pit
2 hrs
cx cut off for miso
3+ cxs per 10 min
terbutaline dosing
0.25 mg SC
what is a significant variable decel
> 60 sec
/= 60 below baseline
</= 60 bpm
gain or loss of 1 unit of blood / 250 cc will change H/H by how much
Hgb 1, Hct 3
500 g = x lb x oz
1 lb 1 oz
bhcg level that will show something on TVUS
1500
bhcg level that will show something on TAUS
2000
what determines IUP on sono
gs + ys/fp
types of retractors (3)
bladder blade
richardson
loop
types of scissors
metz (thin)
straight / suture
bandage
curved mayo (thick)
types of forceps
with and without teeth
adson
russian
difference between metz & mayo scissors
metz = thin
mayo = thick
characteristics of adson forceps
small and fine
hemostats aka
snaps
malleable aka
ribbon
kelly vs kocher
kelly = curved
kocher = straight
instrument that is square shaped with teeth
alice
instrument similar to alice but used for tubal
babcock
average urine output
0.5-1 cc / kg / hr
BPP components
- NST - 15 bpm x 15 sec
- breathing 30+ sec
- movement x 3
- tone x 1 (flexion/extension)
- fluid - mvp 2x2+, afi 5+