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OB/Peds Preceptored Exams (Sem 2) > OB > Flashcards

OB Flashcards

1
Q

Postpartum Period is defined as

A

interval from childbirth to return of the uterus to a NON-PREGNANT state (DOES NOT go back to pre pregnant)

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2
Q

Inovulation

A

the shrinking of the uterus

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3
Q

factors that promote inovulation

A 
early/frequent ambulation
uterine contractions (2-3 days postpartum)
breast feeding (release oxytocin/petocin)
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4
Q

by what week should the uterus no longer be palpable

A

2nd week postpartum

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5
Q

Subinvolution

A

failure of the uterus to return to a non-pregnant state

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6
Q

factors that cause subinvolution

A 
full bladder
multiparius women (increased risk of hemmorhage)
prolonged labor (>18 hours)
anastesia (epidural)
infection
retained placenta fragments
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7
Q

characteristics of colostrum

A

increased nutrients/antibodies
low in fat
high protein

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8
Q

what does a fundal rub do

A

makes the uterus contract and prevents hemmorhage

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9
Q

estimated blood loss for a vaginal delivery

A

500mL

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10
Q

estimated blood loss for a C-section

A

1,000mL

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11
Q

what should you have the patient do before performing a fundal rub

A

empty their bladder

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12
Q

how long does the post partum period last

A

6 weeks

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13
Q

lochia rubra is seen when

A

after birth

3-4 days

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14
Q

lochia serosa (pink/brown) is seen when

A

22-27 days post partum

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15
Q

lochia alba (white) is seen when

A

up to 6 weeks post partum

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16
Q

what should you assess when looking at lochia

A

amount
color
odor

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17
Q

what is considered heavy lochia

A

saturated peri-pad within 1 hour

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18
Q

episiotomy

A

purposeful cut of the perineum

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19
Q

how long does it take for a perineal laceration to heal

A

2-3 weeks

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20
Q

concerns surrounding an episiotomy

A

infection

comfort

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21
Q

education/treatment for episiotomy

A 
ice to perineum 
increase fiber
stool softeners
encourage urination
ease fear of voiding
sitz bath
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22
Q

indications for a c-section

A

baby is large

baby is in distress (decrease in HR)

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23
Q

post partum care for a c-section

A 
bed rest for 12 hours
wear SCD's (sequental compression devices on calves) for DVT/blood clots
check incision site
infection control
STILL HAVE TO DO FUNDAL RUBS
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24
Q

how long do clotting factors stay elevated after birth

A

6 weeks

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25
Q

what can the mother take for soreness/pain

A

Ibuprofen

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26
Q

what can happen to a womans hair after birth

A

becomes coarse/falls out (due to hormones)

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27
Q

when is it normal to see elevated WBC’s

A

during the post partum period (6 weeks)

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28
Q

if a woman is Rubella Equivical, what does this mean

A

she needs the MMR vaccine

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29
Q

what is important education regarding the MMR vaccine when given post partum

A

avoid pregnancy for 28 days

it DOES NOT transfer through breast milk

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30
Q

what does it mean when the uterus is displaced to the left

A

the bladder is full

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31
Q

what can a full bladder cause in the post partum period

A

they inhibit uterine contractions

can cause hemmorhage

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32
Q

how early can a menstrual cycle return after giving birth

A

as soon as 28 days

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33
Q

what is a normal characteristic of the first 3-4 menses after birth

A

heavy bleeding

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34
Q

does bowel motility increase or decrease after birth

A

decrease

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35
Q

what is important for pregnant women regarding bowel movements

A

stool softeners

eat high fiber

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36
Q

what is the headache caused by an epidural called

A

spinal headache

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37
Q

what causes a spinal headache

A

leaking of the spinal fluid from the epidural space

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38
Q

how is a spinal headache diagnosed

A

if the mom lays flat/supine, the headache will go away

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39
Q

what should you do for a spinal headache

A

call anesthesia, will perform a blood patch

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40
Q

biggest education to give parents regarding their newborn

A 
SAFETY
varify ID of anyone who enters the room
call to verify
security tags on the newborn
be aware of what they post on social media
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41
Q

what does a uterus displaced to the right mean

A

placenta fragments

holding onto a clot

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42
Q

does a gush of blood after the mom stands mean a sign of hemmorhage

A

no, blood was pooling when sitting

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43
Q

how long is the first period of reactivity

A

30 minutes after birth

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44
Q

heart rate of newborn is typically

A

120-160 bpm

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45
Q

what can normally indicate respiratory distress in a newborn but is normal in the first period of reactivity

A

grunting and nasal flaring

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46
Q

Moros Reflex

A

also known as the startle reflex

something makes the baby jerk

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47
Q

second period of reactivity

A

2-8 hours

48
Q

what occurs in the second period of reactivity

A

meconium is passed (black, tarry, sticky stool)

have up to 24 hours to pass it

49
Q

neonatal period

A

birth-28 days

50
Q

what are the 6 important things that occur in the neonatal period

A 
establish/maintain respirations 
experience circulatory changes 
ingesting/digesting nutrients
eliminate/regulate weight
learn to regulate temperature
establish relationships
51
Q

how long is the passive immunity sufficient for the baby from mom

A

3 months

52
Q

what are the characteristics of the GI system at birth

A

sterile and immature

53
Q

how long does the baby have to pass meconium before there is cause for concern

A

24 hours

54
Q

normal characteristics of the female reproductive system at birth

A

vaginal discharge
spotting
edema
vernix (cheese-like)

55
Q

normal characteristics of the male reproductive system at birth

A

two palpable testes

hydrocele

56
Q

hydrocele

A

fluid in the scrotum

resolves without treatment

57
Q

Hypospadias

A

urethra is on the ventrial space of the penis

58
Q

Epispadias

A

urethra is on the dorsal side

59
Q

Ortiolanis Maneuver

A

femoral head moves in and out

checks for hip displasia

60
Q

treatment for hip displasia in baby

A

double diaper
harness
surgery

61
Q

Unconjugated/Indirect Jaundice characteristics

A

can cross the BBB
can cause neurotoxicity (Kernicterus)
fat-soluble

62
Q

Kernicterus

A

neurotoxicity caused by Jaundice

63
Q

Conjugated/Direct Jaundice characteristics

A

water soluble

excreted in waste (feed baby so it poops/pees)

64
Q

what is pathologic jaundice caused by

A

maternal newborn blood type incompatibility

65
Q

education given to parents for jaundice

A 
starts in sclera
works its way down the body
may be lethargic, not wanting to eat
keep the baby near a window
feed plenty
phototherapy
66
Q

what is important to do when a baby is receiving phototherapy

A 
protective goggles
diaper on
check hydration status
monitor temperature
I's/O's
67
Q

what can persistant tachycardia mean in a newborn (>160)

A

anemia
hypovolemia
sepsis
hyperthermia

68
Q

what can persistent bradycardia mean (<100)

A

heart block

hypovolemia

69
Q

RBC’s at birth

A

elevated due to fetal circulation being less effective at oxygen exchange

70
Q

WBC’s at birth

A

normal to be elevated

71
Q

Platelets at birth

A

decreased
(immature live/GI)
decreased clotting factors
not able to synthesize Vitamin K (give supplemental Vitamin K)

72
Q

oxygen flow of newborn

A

oxygen poor=right side

oxygen rich=left side

73
Q

what does the cutting of the cord do

A

increases BP

increases perfusion to the lung

74
Q

what occurs in Cold Stress

A

oxygen drops

75
Q

as a baby learns to breathe, what occurs

A

they become better eaters

76
Q

alveoli are lined with what to make breathing easier

A

surfactant

77
Q

when does the transition from intrauterine to extrauterine begin

A

when the umbilical cord is clamped

78
Q

s/s of respiratory distress in an infant

A 
retractions (can see)
stridor (can hear)
episodes of apnea
acracyanosis (blue/purple of feet and hands after 24 hrs)
central cyanosis (mouth/chest)
79
Q

Caput Succedaneum

A

normal
edema of the head
crosses OVER the suture line

80
Q

Cephalhematoma

A

DOES NOT cross over the suture line
well defined
blood between skin and skull

81
Q

what can cephalhematomas cause

A

Jaundice when they begin to break down

82
Q

Mongolian Spots

A

look like bruises
coccyx/back
IMPORTANT: document, look like bruises

83
Q

Nevi (Stork Bites)

A

flat pinkish/red birthmark/rash
found on forhead/eyelids/back of neck
fade, dont always go away

84
Q

Erythema Toxicum

A

newborn rash
no treatment
no lotion

85
Q

Babinskis

A

big toe flexes, others fan out

disappears 1-2 yrs (if it lasts longer, neuro damage)

86
Q

Palmers Grasp

A

place object in hand, grasp

87
Q

Plantar Grasp

A

curl toes around the object

88
Q

why are newborns at risk for heat loss

A

very thin layer of fat

blood vessels are close to the surface

89
Q

APGAR tells us

A

how the baby is transitioning to extrauterine life

90
Q

what is assessed with an APGAR score

A 
HR
RR
Muscle Tone
Irritability
Color
91
Q

what occurs if the APGAR is <7

A

repeat every 5 minutes until it is greater than 7

92
Q

0-3 means what for APGAR

A

severe distress

93
Q

4-6 on APGAR means

A

moderate distress

94
Q

what is the priority as soon as a baby is born

A

to establish RR

95
Q

what can increase/help establish RR

A

tactile stimulation (dry the baby)
skin to skin
cap on the head

96
Q

how should you use bulb suction

A

MOUTH then NOSE

nose first causes aspiration of what is in the mouth

97
Q

where should you check a newborns O2 Sat

A

preductal (right hand)

98
Q

what is an expected finding of the 02 Sat as soon as the baby is born

A

low (can be as low as 60)

poor because of oxygen being shunted to the lungs

99
Q

when does the anterior fontanel close

A

around 18 months

100
Q

how many vessels should be in the umbilical cord

A

3

101
Q

what are the 3 standard medications a newborn receives

A 
Erythromyocin (antibiotic for eyes)
Vitamin K (needed for clotting)
Hepatitis B (mom must sign consent form)
102
Q

where is a babies BGL taken

A

lateral aspect of the heel

103
Q

what is considered hypoglycemia for a baby

A

<45

104
Q

how is a CCHD (Critical Congenital Heart Defect) test performed

A

look at O2 Sat
preductal (right hand)
Postductal (either foot)
tested at same time

105
Q

what must occur for the newborn to pass a CCHD test

A

> 95%
must be within 3% of each other
even if both in range, must be within 3% of each other

106
Q

Hyperbilliruibinemia is also known as

A

Jaundice

107
Q

what must happen after a circumcision in order for the baby to be discharged

A

must void

108
Q

education for mom regarding circumcision

A

hygiene
keep gauze pad and ointment on it
never a dry gauze pad, it will stick

109
Q

what promotes lactation/lactogenesis

A

decrease in progesterone

release of prolactin

110
Q

what hormone is ESSENTIAL for lactation and is released because of nipple stimulation

A

oxytocin

111
Q

what two things is Oxytocin responsible for in lactation

A

milk ejection

milk let down

112
Q

what is the proper way to unlatch a baby from the breast

A

place finger in mouth to release suction

113
Q

what are contraindications to breast feeding

A

baby has Galactosemia (inability to process protein in milk)

if mom has active TB or HIV

114
Q

what are the recommendations regarding breast milk and babies

A

only breast milk for 6 months

receive breast milk for 2 years

115
Q

what is important to educate on with formula feeding

A

DONT PROP BOTTLE

burp after 15mL (if spitting up during feeding, burp more frequently)

116
Q

when should complementary feeding begin

A

at 6 months

wait 3-5 days before introducing new foods

OB/Peds Preceptored Exams (Sem 2) (2 decks)

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