OB Flashcards
Gravida
Gravida- # of times a woman has been pregnant including current pregnancy
Term
number of pregnancies after 37 weeks
(twins and triplets count as one)
Preterm
number of pregnancies between 20-36 weeks
(twins and triplets count as one)
Abortions
number of loses before 20 weeks
(twins and triplets count as one)
Living
number of living children
What is the best treatment for morning sickness?
High protein snack before getting out of bed
- drink fluids before or after meals
Foods to avoid for heartburn
Chocolate, peppermint, and caffeine
Rubella vaccine
if no past rubella vaccine has been given do not give during pregnancy, wait until after birth
wait 1 month before getting pregnant after getting
Herpes with active lesions treatment and delivery
treat with acyclovir- antiviral therapy
need c section
ectopic pregnancy
egg implants outside uterus, most common in Fallopian tube
ectopic pregnancy risks
- recurrent STIs (Chlamydia)
- PID
-IUD - Tubal damage
ectopic pregnancy diagnostics
positive HCG and empty uterus upon ultrasound
ectopic pregnancy s/s
- red spotting
- 1 sided lower abdominal pain
Ruptured ectopic pregnancy
causes shock and peritonitis
- early sign sudden, severe or sharp shoulder pain
low bp, hr, dizziness
- rigid abdomen, tenderness, fever
Preeclampsia and s/s
high bp causing organ damage starting around 20 weeks
s/s: - bp over 140
- bp 15 higher than last visit
- proteinuria
- abd pain and body swelling
- weight gain
- seizures (eclampsia)
- headache and blurred vision
HELLP and critical signs
Hemolysis Elevated Liver enzymes Low Platelets
Critical Signs:
-3rd trimester with right upper quadrant pain
- nausea & vomiting
headache blurred vision
Treatment for HELLP and Preeclampsia
Magnesium Sulfate (Mellows the body)- Prevents seizures
Therapeutic range: 4 - 7 mEq/L
- assess hr, rr, reflexes, and UO all decrease when toxic
- beta blockers
- calcium channel blockers- nifidepine and cardiazem
- vasodilators- hydralizine
Placenta abruption, s/s and treatment
placenta detaches for the uterine wall causing hemorrhage and no oxygen to baby
s/s: dark red bleeding, painful rigid abdomen, uterine tenderness
treat: IV fluid and blood for shock and emergency c section
Placenta Previa, s/s, and treatment
placenta is over the cervix making vaginally delivery not possible
s/s: painless bright red bleeding, low h and h
- no sex, douching or vaginal exams
- bedrest
- give blood and count pads
Preterm labor risk factors and treatment
distended uterus, short cervical length, periodontal disease, history of preterm births
cerclage- sutures in the cervix to keep it closed removed before delivery
education: bedrest, no sex
Forceps and vacuum use
never apply fundal pressure when using= causes uterine rupture
Uterine inversion
placenta fails to detach from the uterine wall and pulls uterus inside out
s/s: abd pain, bleeding
treatment: Relax the uterus: (Tocolytic) Terbutaline
Magnesium sulfate
2. Provider repositions the uterus
3. AFTER the uterus is repositioned Oxytocin
4. IV fluids & blood products
PROM Complication and Treatment
Premature rupture of membranes before 34 weeks
give antibiotics to prevent GBS infection if rupture is over 18hrs ago
best rest
Corticosteroids to help develop the fetus’s lungs.
Antibiotics to prevent infection and prolong the pregnancy.
Tocolytics (medication to stop labor).
Magnesium sulfate to help the fetus’s brain
test fluid : ph blue or greater than 6 is amniotic fluid
AROM Complication
Artificial rupture of membranes
risk for cord prolapse
overterm baby
crackled dry, peeling skin
crackles immediately after birth
normal
crackles hours after birth
report
sacral dimples
not normal spina bifida or myelomenigoele- paralysis
no bowel sounds after birth
normal will increase with feeding
Meds given after birth
erythromycin ointment
vitamin K and hep b in vastus lateralis
Vital signs for newborns
hr, rr, bp, glucose
hr- 110- 160
rr- 30-60
glucose 40 or more
temp- 99.5
bp 77/55
Naegele rule
last day of menstrual period
+ 7 days
- 3 months
total estimated weight gain during pregnancy
25-31 pounds
Week gain during first trimester
1 pound per month
3lbs total
Weight gain during 2nd and third trimester
1lb per week
Ideal weight gain for specific pregnancy week
number of weeks plus 9
if within 1-2 lbs fine
+/- 3 assess
+/- 4 trouble perform bpp
