OB Flashcards
What is the Naegele rule for estimating the date of delivery?
Take the first day of last menstrual period (LMP), add 7 days and subtract 3 months.
How much weight is typically gained during the first trimester of pregnancy?
1 lb per month, totaling 3 lbs.
What is the ideal weight gain during pregnancy?
28 lbs, plus or minus 3 lbs (between 25 to 31 lbs).
What is the quick method to estimate ideal weight gain during pregnancy?
Take the number of weeks gestation minus 9.
If a woman is in her 28th week gestation and gained 22 lbs, how much weight does she have compared to the ideal?
3 lbs extra than her ideal weight.
If a pregnant woman at 31 weeks gestation gained 15 lbs, how much less is she than the ideal weight?
7 lbs less than the ideal.
What is the significance of fundal height being palpable?
It helps determine the trimester of pregnancy and can indicate abnormalities like molar pregnancy.
What are the positive signs of pregnancy?
- Fetal skeleton on x-ray
- Presence of fetus on ultrasound
- Auscultation of fetal heart (Doppler)
- Examiner palpates fetal movement.
What is the earliest gestational age at which fetal heart can first be heard?
8 weeks.
What is Chadwick sign?
Cervical color change to cyanosis (blue discoloration).
What is the recommended schedule for prenatal visits?
- Once a month until week 28
- Every other week between 28 and 36
- Once a week after week 36 until delivery or week 42.
What is the normal hemoglobin (Hb) range for pregnant women during the first trimester?
Can fall to 11 g/dL and be perfectly normal.
How is morning sickness typically treated?
Dry carbohydrates before the patient gets out of bed.
What should a pregnant woman do if she experiences difficulty breathing during the second or third trimester?
Assume the tripod position.
What is the most valid sign that a woman is in labor?
Onset of regular/progressive contractions.
What does dilation refer to during labor?
Opening of the cervix from 0 to 10 cm.
What is the definition of effacement?
Thinning of the cervix.
What is the significance of a station of 0?
The presenting part is at the ischial spines.
What are the phases of Stage 1 labor?
- Phase 1: Latent (0 to 4 cm)
- Phase 2: Active (5 to 7 cm)
- Phase 3: Transition (8 to 10 cm).
What is the primary purpose of uterine contractions in the first stage of labor?
Dilation and effacement of the cervix.
What is the primary priority during the second stage of labor?
Clearing the baby’s airway.
What is uterine hyperstimulation?
Contractions lasting longer than 90 seconds and closer than 2 minutes.
What does the acronym ‘LION’ stand for in obstetric emergencies?
- Left side (place mother on the left side)
- IV
- Oxygen
- Notify HCP.
What is the normal fetal heart rate range?
120 to 160 beats per minute.
What should be done if the fetal heart rate is below 110?
Implement ‘LION’ protocol.
What position should a woman be in for back pain during labor?
Knee-chest position.
What is the purpose of the third stage of labor?
Delivery of the placenta.
When does postpartum technically begin?
2 hours after delivery of the placenta.
What is considered a Low Fetal HR?
HR <110
This is BAD.
What does ‘LION’ stand for in response to Low Fetal HR?
- Left side
- IV
- Oxygen
- Notify HCP
Stop Pitocin if it was running.
What is considered a High Fetal HR?
HR >160
Document acceleration of fetal HR.
What should be done if Low Baseline Variability is detected?
- Left side
- IV
- Oxygen
- Notify HCP
Stop Pitocin if it is running.
What does High Baseline Variability indicate?
This is GOOD
It means fetal heart rate is always changing.
What is an Early Deceleration?
This is normal
Document finding.
What are Variable (VERY) Decelerations indicative of?
Prolapsed cord
Nursing intervention: PUSH and POSITION.
What does a Late Deceleration indicate?
This is BAD
Do ‘LION’.
What are the steps in the second stage of labor and delivery?
- Deliver head
- Suction the mouth then the nose
- Check for nuchal cord
- Deliver shoulders and body
- Ensure baby has ID band
This stage is about order.
What is checked during the delivery of the placenta?
- Ensure placenta is complete and intact
- Check for 3-vessel cord (2 arteries and 1 vein)
AVA refers to Arteries, Vein, and Arteries.
What are the four assessments to perform every 15 minutes in the fourth stage of labor?
- Vital signs
- Fundus
- Perineal pads
- Roll the patient
Assess for shock and bleeding.
What does ‘BUBBLE HEAD’ stand for in postpartum assessment?
- Breasts
- Uterine fundus
- Bladder
- Bowel
- Lochia
- Episiotomy
- Extremities
- Affect
- Discomforts
Focus on the three designated steps: Fundus, Lochia, Thrombophlebitis.
What is the normal tone of the postpartum uterine fundus?
Firm, not boggy
Fundus should be at umbilicus after delivery.
What are the stages of lochia postpartum?
- Rubra—red
- Serosa—pink
- Alba—white
Moderate amount: 4 to 6 inches on pad in an hour. Excessive: saturate a pad in 15 minutes.
What is the best way to determine if a patient has thrombophlebitis?
Measure Bilateral calf circumference
Homan sign is not the best answer.
What is Milia in newborns?
White, pinhead-size, distended sebaceous glands
Usually disappear after a few weeks of bathing.
What is a Cephalohematoma?
A collection of blood between the periosteum and skull bone
Develops within the first 24 to 48 hours after birth.
What is Caput succedaneum?
Edema of the scalp during birth from mechanical trauma
Edema crosses suture lines.
What is physiologic jaundice in newborns?
Normal jaundice appearing after 24 hours of birth
Disappears in about one week.
What is the purpose of Vernix caseosa?
Protect the skin from amniotic fluid exposure
It is a fatty, whitish secretion from fetal sebaceous glands.
What are the side effects of Terbutaline?
Maternal tachycardia
Do not give with cardiac disease.
What nursing intervention is needed for hypermagnesemia due to magnesium sulfate treatment?
Monitor respiration
If RR <12, decrease dose of magnesium sulfate.
What is the nursing intervention for uterine hyperstimulation due to Pitocin?
Lower the dose of Pitocin
Uterine hyperstimulation is defined as contractions longer than 90 seconds, closer than 2 minutes.
Uterine contractions should be ___ than ___ seconds and ____ than __ minutes
No longer than 90 seconds and no closer than 2 minutes
Stage 1 - Active Phase measurements
Cervical dilation 5 - 7 cm
Contractions 3-5 minutes apart, last 30-60 seconds
Slower = latent
Faster = transition phase
