OB

Question 1

normal maternal changes (6)

Answer 1

1) HR increases2) B/P decreases in the 2nd trimester, returns to normal in 3rd trimester3) CO increases4) plasma increases 40%, >increase in clotting factors, risk of PE5) hormones: progesterone and relaxin relaxes sphincters6) decreased functional/residual lung volume

Question 2

normal maternal changes (6)

Answer 2

1) HR increases2) B/P decreases in the 2nd trimester, returns to normal in 3rd trimester3) CO increases4) plasma increases 40%, >increase in clotting factors, risk of PE5) hormones: progesterone and relaxin relaxes sphincters6) decreased functional/residual lung volume

Question 3

Assessment “DES”

Answer 3

dilationeffacement (thickness of cervix) station (fetal head relation to pubic bone)

Question 4

Normal FHR 120-160 fetal tachycardia due to……fetal bradycardia due to…..

Answer 4

………….sepsis………….hypoxia

Question 5

variability #1 cause of poor variability

Answer 5

normal variability = 10-15 bpm …..fetal hypoxia

Question 6

general rule regarding accelerations/decelerations

Answer 6

in relation to uterine contraction. accelerations are always gooddecelerations can be bad

Question 7

early decelerations

Answer 7

they mirror contractionsthe head is pressed against the cervixbenign

Question 8

variable decelerations

Answer 8

caused by cord compression during uterine contraction

Question 9

sinusoidal variations

Answer 9

caused by accidental tap of the umbilical cord, fetal hypovolemia, anemia, acidosis

Question 10

Assessment “DES”

Answer 10

dilationeffacement (thickness of cervix) station (fetal head relation to pubic bone)

Question 11

Normal FHR 120-160 fetal tachycardia due to……fetal bradycardia due to…..

Answer 11

………….sepsis………….hypoxia

Question 12

variability #1 cause of poor variability

Answer 12

normal variability = 10-15 bpm …..fetal hypoxia

Question 13

general rule regarding accelerations/decelerations

Answer 13

in relation to uterine contraction. accelerations are always gooddecelerations can be bad

Question 14

early decelerations

Answer 14

they mirror contractionsthe head is pressed against the cervixbenign

Question 15

variable decelerations

Answer 15

caused by cord compression during uterine contraction

Question 16

sinusoidal variations

Answer 16

caused by accidental tap of the umbilical cord, fetal hypovolemia, anemia, acidosis

Question 17

Anaphylactoid Syndrome of Pregnancy

Answer 17

caused by maternal exposure to fetal cellsDIC and anaphylaxis Symptoms: pleuritic chest pain, tachypnea, tachycardia, feverTx: fluid resuscitation, increase PEEP, FFP, Plts, Cryoprecipitate

Question 18

Meconium

Answer 18

inactivates surfactant. deep suction only if baby is not vigorous

Question 19

umbilical cord prolapse

Answer 19

noticed by variable decelerationselevate cord to relieve pressure give tocolytics

Question 20

PIH

Answer 20

can causes placental insufficiency tx options: labetolol (beta blocker), hydralazine (alpresoline), methyldopa (levodopa)

Question 21

McRobert’s maneuver

Answer 21

for shoulder dystocia, knees to chest, and application of suprapubic pressure

Question 22

Mauriceau’s maneuver

Answer 22

breech delivery use of fingers to relieve pressure from the baby’s nose and applying downward suprapubic pressure

Question 23

HELLP

Answer 23

Hemolysis/Elevated Liver Enzymes/Low Plateletsseen with pre-eclampsia and eclampsiaRUQ pain (liver), jaundice, malaise give Mag Sulfate, steroids (to stimulate fetal lung maturity), hypertension (use labetalol, hydralazine, or methyldopa)

Question 24

HTN, proteinuria, edema

Answer 24

pre-eclampsia, eclampsia

Question 25

pre-eclampsia s/srisk factorsFHM

Answer 25

no seizures HTN, proteinuria, edemaextremes of age, 1st pregnancy

Question 26

placenta abruption

Answer 26

painful bleedingMVA or blunt traumaexsanguination or placental insufficiency

Question 27

placenta previa

Answer 27

painless bright red bleedingavoid vaginal exams

Question 28

postpartum hemorrhage

Answer 28

> 500mL blood loss (24 hours after delivery)

Question 29

uterine rupture

Answer 29

“stomach is hard as a board” (caused by peritonitis) fetal parts show through mother’s skin

Question 30

If mother is Rh negative….

Answer 30

always give Rhogam because the majority of the population are Rh positive and the mother has Rh antibodies