OB Flashcards
What is conduction?
transfer of heat from one object to another when the two objects are in direct contact with each other
- cold mattress, scale, circumcision board
What is convection?
flow of heat from the body surface to cooler surrounding air or to air circulating over a body surface; breeze from a window being open
- cool breeze that flows over the newborn
- keep away from doors & windows
What is evaporation?
loss of heat when a liquid is converted to a vapor
- when baby is born and covered in amniotic fluid then the air evaporates it
What is radiation?
loss of body heat to cooler, solid surfaces that are in proximity but not in direct contact with the newborn; standing near the closed window; close proximity
What is naegel rule?
first day of last normal period - 3 months + 7 days + 1 year
Why do we give Rhogam?
given to prevent cell insensitive
given when a mother is - and a fetus is +
Coombs test for Rhogam?
antibody screen to determine isoimmunity to Rh antigen
What is GTPAL?
Gravida/ Term (38-42 weeks)/ Preterm (~20-37 weeks)/ Abortions (
When is Rhogam given, in terms of timing?
given at 28-32 gestational weeks and within 72 hours after birth
When does menstruation return for BOTTLE feeding?
6-8 weeks
When does menstruation return for BREAST feeding?
3 months- 1 year
When does the primitive heart fully developed?
week 8.
When can fetal gender be determined?
12 weeks.
What is placenta previa? s/s, NI, and risk factors?
- bleeding condition that occurs during the last two trimesters of pregnancy; placenta implants over the cervical os
- PAINLESS, visible bright red blood
- NI: avoidance of vaginal exams & prepare for possible C section birth
- risk factors: maternal age, multiple C sections, infertility treatments
What is abruptio placentae? s/s, NI, and risk factors
- separation of the normally located placenta after the 20th week of gestation; prior to birth that leads the hemorrhage
- s/s: sudden, constant, PAINFUL, knife-like abdominal pain; blood is dark (visible or concealed)
- NI: volume replacement (2 large bore IV & transfusion of fresh-frozen plasma), bed rest in left lateral position, alert for signs of DIC (bleeding gums, tachycardia, oozing from IV site, petechiae), catheter
What is mild preeclampsia? and NI?
> 140/>90 after 20 weeks, resolving 12 weeks
may be placed on bed rest (on lateral recumbent position)
monitor BP every 4-6 hours while awake
What is eclampsia?
> 160/ >110 with marked proteinuria and seizure
What is admin to prevent seizure/ further seizure?
magnesium sulfate
What is kept at the bedside to prevent magnesium toxicity?
What are the s/s of toxicity?
calcium gluconate
decreased respirations and loss of deep tendon reflexes
When do organs begin to form?
4 weeks.
When do we screen woman for gestational diabetes?
- screen at 1st prenatal visit; recheck for all high risk pregnant woman at 24-28 weeks
- infants can be large or small
What happens when LH surges?
Responsible for affecting the final development and rupture of the mature follicle at the time of OVULATION to produce estrogen.
What is the function on FSH?
Stimulates the ovary to produce 5-20 immature follicles, Highest and most important during first week of follicular phase.
What are x-linked recessive inheritance disorders? (3)
- Hemophilia
- Color Blindness
- Duchenne muscular dystrophy
How is x-linked recessive disorders passed on?
No male-to-male transmission. Any man with disorder will have carrier daughters.
If a woman is a carrier: 25% chance of affected son, 25% carrier daughter. 25 % chance of unaffected son, 25% non carrier daughter.
What are the three types of lochia’s?
lochia rubra- deep-red; first 3-4 days
lochia serosa- pinkish brown; 3-10 days
lochia alba- creamy white or light brown; 10-14 days and can last 3-6 weeks
*C-sections have less blood
How does postpartum psychosis differ from depression?
- Delusion / Hallucinations
- Thoughts of suicide and infanticide
- Extreme disorganization of thought
- Mania and bizarre behaviors.
What immunizations should you not give a pregnant woman? (5)
- MMR and varicella
- TB (BCG)
- Influenza nasal spray (live, attenuated)
- Meningococcal
- Typhoid
GBS– group b strep
mother is screened at 35-37 weeks– if positive, treat with antibiotics prior to birth— if baby contracts it, can develop sepsis, pneumonia, meningitis
If a baby is going through cold stress, what can’t you give?
Insulin.
Signs and symptoms of cold stress: (6)
- Lethargic
- Hypotonic
- Weak
- Glucose consumption leading to hypoglycemia.
- Oxygen and respiratory issues
- Acidosis and jaundice
What is the duration of the pre-embryonic stage?
fertilization- 2nd week
What is the duration of the embryonic stage?
end of the 2nd week-8th week
What is the duration of the fetal stage?
end of the 8th week-birth
Signs and symptoms of low platelets?
Bleeding, bruising, and petechiae.
What is the role of the baby in a mother who has digestion diabetes?
The result is hypoglycemia as glucose is diverted to the fetus
What is Chadwicks sign?
Bluish-purple coloration of vaginal mucosa and cervix
approaching parents about fetal loss
provide mementos to validate death
allow unlimited time with stillborn
couples need to talk about it with the RN listening
assist in grief process to prep for future pregnancies
What is HELLP and the s/s?
Hemolysis- resulting in anemia and jaundice
Elevated Liver enzymes
Low Platelet count
s/s: nausea, malaise, epigastric or RUQ pain, demonstrable edema
What is the BP range and treatment for severe preeclampsia/ HELLP?
> 160/>110, proteinuria >500 mg in 24 hours
treatment: delivery of baby via vaginal delivery
What is lightening?
Fetal head begins to descend into the pelvis. Breathing becomes easier but pressure in lower back and bladder (increasing urinary frequency).
What is quickening?
When the woman begins to feel or perceive fetal movements for the first time.
Signs and symptoms of low platelets?
Bleeding, bruising, and petechiae.
s/s of amniotic fluid embolism:
most common is difficulty breathing
What is the role of the baby in a mother who has digestion diabetes?
The result is hypoglycemia as glucose is diverted to the fetus
why do we do amniocentesis?
- to detect chromosomal abnormalities and several hereditary metabolic defects in the fetus before birth
- used to confirm fetal abnormalities
- genetic abnormalities tested at 11 and 14 weeks
- rather than a “best guess” diagnosis
Where is the baby at zero (0) station?
The presenting part is even to the ischial spines.
Where is the baby if they are -1 station?
1 cm above ischial spines.
Where are FSH and LH released from?
Anterior pituitary
