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CFRN Studying > OB > Flashcards

OB Flashcards

1
Q

OB Physiological Changes

A

Up to 50% increase in blood volume “Anemia of pregnancy”
Decreased Tidal Volumes
HR increased by 10-20 bpm

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2
Q

Report Info

A

Gravida - Number of pregnancies
Para - Number of live births
Number of abortions under 20 weeks
Gestational Age

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3
Q

Fetal Assessment

A

Fundal Height

20 wks: Fundus should be at umbilicus.
36 wks: Sternum

Station: Measured -3-+3 - “dropping”

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4
Q

FHR Variability

A

Healthy fetal heart rate variability reflects a healthy CNS and cardiac function.

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5
Q

Decreased FHR Variability

A

Fetal hypoxia
Prematurity
Congenital heart problems

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6
Q

Increased FHR Variability

A

Fetal Hypoxia
Mechanical compression of umbilical cord

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7
Q

Fetal Bradycardia

A

<120 bmp >5-10m

Cord compression
Cord prolapse
Anesth esia to spinal cord
Maternal seizures

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8
Q

Fetal Tachycardia

A

> 160bpm >5-10m

Fetal Hypoxia
Maternal Fever
Anemia
Hyperthyroidism

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9
Q

Accelerations

A

Increased roughly 15 bpm for roughly 10-15 seconds.

Reflective of fetal well-being.

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10
Q

Early decelerations

A

Mirrors contractions

Head is compressed.
Going to canal.

NOT HARMFUL

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11
Q

Late Decelerations

A

At peak of contraction
returns to baseline after contraction

Smooth/shallow dips
WORRISOME - Fetal Hypoxia

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12
Q

Sinusoidal

A

EMERGENCY
No changes in contractions
Sine wave appearance
Fetal anemia/hypoxia

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13
Q

Interventions for fetal distress

A

Oxygen
IV Bolus
Rule out cord prolapse
Lateral Positioning

DC infusion of oxytocin if having tetanic contractions

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14
Q

Pre-Term Labor

A

20-37 wks gestation

Increased Vaginal Discharge
Increased pelvic pressure
Lower backache

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15
Q

Tocolytics

A

CCB, Mg, NSAIDS, NTG, Terbutaline

Contraindications:

Fetal Demise
Lethal fetal anomalies
Severe Pre-eclampsia
Maternal Bleeding
Intraamniotic Infection

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16
Q

Nifedipine

A

> 32 Weeks Gestation CCB

17
Q

Indomethacin

A

NSAID
Cyclooxygenase Inhibitor
<32 weeks gestation

Contraindications:

Platelet dysfunction
Hepatic/renal dysfunction
Hypersensativity to ASA

18
Q

Terbutaline

A

Beta Andrenergic Receptor Agonist
-Off Label for preterm labor
FDA Warning against prolonged use

Contraindications:

Tachycardia Sensitive cardiac disease
Poorly controlled hyperthyroidism/Diabetes
It does cross placenta lines. Can cause tachycardia in fetus.

19
Q

OB Magnesium Sulfate

A

Relatively weak tocolytic effects

Neuroprotection of fetus.

Monitor BP, Respiratory Status, and DTR

Contraindications: Myasthenia Gravis
Cardiac Compromise

Antidote: Calcium Gluconate

20
Q

OB Nitroglycerin

A

Smooth muscle relation.
Monitor blood pressures

21
Q

OB Corticosteroids

A

Betamethasone

Boost development of fetal lung, brain, and digestive systems.
Takes up to 48 hours for full effect

Decreases risk of intraventricular hemorrhage.

22
Q

OB Antibiotics

A

Group B Strep.
Usually given >35 weeks gestation. If less than 35 wks gestation, consider giving antibiotics.

23
Q

Premature Rupture of Membranes

A

Risk to fetus:

Infection
Pre-term delivery
Umbilical cord prolapse/compression

24
Q

Signs of Imminent Delivery

A

1-2 minute contractions
Bloody Show
Urge to bear down
Crowing
ITS COMING

25
Q

Pregnancy Induced Hypertension

A

> 140/90

Weight Gain
Headache
Visual Disturbances
Edema
Oliguria
NO PROTEINURIA

Treatment:

Hydralazine
Labetalol
Nifedipine

26
Q

Preeclampsia

A

Typically diagnosed >20 weeks gestation or <4 weeks post-partum

Hypertension
Weight Gain/Edema
PROTEINURIA

Usually acute onset.

Treatment:

Hydralazine/Labetalol
Mag Sulfate
Valium/Ativan

27
Q

Eclampsia

A

SEIZURES

Immediate delivery of fetus.

Hypertension
weight gain/edema
PROTEINURIA

Manage seizures, hypertension, and deliver baby.

28
Q

HELLP Syndrome

A

Hemolysis, Elevated Liver Enzymes, Low Platelets

RUQ epigastric pain
Headache
N/V
Myalgia

Immediate delivery if >34 weeks.

29
Q

Placenta Previa

A

Placental attachment over opening of cervix
Pain BRIGHT RED bleeding

C section

Supportive Treatment
DEFER VAGINAL EXAM

30
Q

Placental Abruption

A

Premature separation of placenta from uterine wall

Risk of fetal hypoxia and death

Uterine tenderness, board-like abdomen, DARK RED VAGINAL BLEEDING

31
Q

Uterine Rupture

A

Baby is typically outside of the uterus.

Signs of previous C-section?
Watch fundal height or palpable uterine defects.

LOSS OF FETAL STATION

Support Care:

Blood
Oxytocin
DELIVERY

32
Q

Nuchal Cord

A

Variable Decelerations
Somersault Maneuver
Clamp and cut before shoulder delivery

33
Q

Post-Partum Hemorrhage

A

> 500ml in vaginal
1000ml in Cesarean

Causes: 4 T’s

Tone - atony
Trauma - tears, rupture
Tissue - retained placenta?
Trombosis - coagulopathy

Fluid/Blood
External Uterine Massage
Oxytocin for uretal atony
Pitocin, Methergine, Cytotec
Blood
Bimanual Uterine Compression

34
Q

Uterine Inversion

A

Supportive Care

DO NOT REMOVE THE PLACENTA
- Stop uterotonic medications

(johnson maneauver)

35
Q

Anaphylactoid Syndrome

A

Antibody response to amniotic fluid and fetal components entering maternal circulation

Hypoxia, hemodynamic compromise/instability, coagulopathy (petichae, contusion)

Supportive Care:

Corticosteroids
Epinephrine
PRBC’s, FFP, Cryopreceipitate

CFRN Studying (23 decks)

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