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ABSN > OB exam 1 - Antepartum 2 > Flashcards

OB exam 1 - Antepartum 2 Flashcards

1
Q

how to alleviate N/v

A

-eat crackers/toast before getting up
-SFM
-avoid greasy or spicy foods
-drink carbonated bevs

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2
Q

how to alleviate urinary frequency

A

void every 2 hrs during the day

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3
Q

how to alleviate fatigue

A

nap

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4
Q

how to alleviate breast tenderness

A

wear a supportive bra

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5
Q

how to alleviate increased discharge

A

-bath dialy
-wear cotton underwear
-avoid douching

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6
Q

how to alleviate nasal stuffiness

A

-cool air
-normal saline spray

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7
Q

how to alleviate heart burn

A

take combination non sodium antacid

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8
Q

how to alleviate ankle edema

A

-avoid prolonged sitting or standing
-keep feet & legs elevated
-hydrate
-socks above knees

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9
Q

when are we concerned about ankle edema

A

it is caused by decreased venous return and we are concerned if it is not relieved by rest or if it spreads to generalized edema

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10
Q

how to alleviate varicose veins

A

-regular exercise
-avoid prolonged sitting or standing

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11
Q

how to alleviate flatulence

A

-keep regular bowel habits
-avoid gas producing foods

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12
Q

how to alleviate hemorrhoids

A

-avoid constipation
-gentle self reduce them
-topical ointments
-warm soaks/sitz baths

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13
Q

how to alleviate constipation

A

-increase fluids & roughage
-daily exercise
-regular bowel habits

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14
Q

how to alleviate backache

A

-pelvic tilt exercise
-good posture
-avoid fatigue
-good body mechanics when lifting

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15
Q

when are we concerned about backaches

A

when it comes and goes regularity

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16
Q

how to alleviate faintness

A

-sit down and lower head between knees
-avoid standing in one place too long

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17
Q

how to alleviate SOB

A

-good posture when sitting
-prop up in bed

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18
Q

how to alleviate difficulty sleeping

A

-avoid caffeine
-maximize comfort in bed

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18
Q

how to alleviate round ligament pain

A

warmth to abdomen

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19
Q

how to alleviate carpal tunnel syndrome

A

-avoid repetitive hand movements
-wear splints
-may disappear after delivery but if not then surgery

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20
Q

when are we concerned of SOB

A

when it the timing doesn’t make sense -> SOB after doing stairs is normal and not concerning, if the SOB doesn’t go away with rest tho after stairs or just at rest then it is concerning

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21
Q

what do we do if a pregnant women is having difficulty breathing

A

-apply pulse ox
-listen to lungs
-resp assessment

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22
Q

how to alleviate leg cramps

A

-massage
-warm soaks
-stretching exercises
-dorsiflex the foot

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23
Q

when is fetal movement usually noted

A

between 16-22 wks 20

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24
Q

how to check fetal movement counts

A

take same time every day (suggest 1 hr after eating or when in a side lying position) and count the # of times baby moves within 1 hour+

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25
Q

when to contact HCP in regards to concerns of fetal movement

A

if the baby has less than 10 movements in 2 hours

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26
Q

a patient calls you saying she has low fetal movement, what is our initial response

A

ask the patient if they have eaten, laid down, and did you have an empty bladder
if the answer to all of these is yes then contact HCP

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27
Q

breast care

A

-supportive bra
-cleanliness
-no soap on nipples
-breast shields for inverted nipples during last 3-4 wks of preg

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28
Q

what type of clothing should be avoided during pregnancy

A

-restrictive clothing
-no high heeled shoes

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29
Q

how to avoid hyperthermia

A

esp during first trimester
no hot tubes or staying in too warm of water

30
Q

do you have to stop working if you’re pregnant

A

no but you may have to modify you role depending on your job and the demands
stop working if put on bedrest or if there are environmental hazards that can not be avoided

31
Q

what are the travel restrictions during pregnancy

A

usually none
-might need to stop or modify if there is a complication w/ the pregnancy
-airlines can restrict you from flying to reduce risk of person going into labor on plane

32
Q

car safety during pregnancy

A

-if long trip stop every 2 hrs and walk for 10 mins
-use shoulder and lab portion of the seatbelt
lap belt goes under abd.

33
Q

rules of exercise & pregnancy

A

-do not pick up a new activity/sport unless walking or healthful practices
-avoid overheating
-ensure nutrient & hydration needs are met

34
Q

contraindications of exercise in pregnancy

A

-water broke/ROM
-cervical insufficiency
-vaginal bleeding
-high BP
-preterm labor
-placenta previa after 26th wk

35
Q

what decreases sexual activity during 1st trimester

A

fatigue
nausea
vomiting

36
Q

what decreases sexual activity during 2nd trimester

A

vascular congestion
least amount of discomfort, highest sex drive

37
Q

what decreases sexual activity during 3rdtrimester

A

fatigue
SOB
decreased mobility

38
Q

what needs to be avoided during pregnancy at dental check up

A

X rays

39
Q

goals for immunization

A

be up to date before pregnancy bc live vaccines cannot be given during pregnancy

40
Q

what vaccine is always given in the 3rd trimester

A

Tdap bc newborns cannot get it so vaccinated the mother provides protection to the baby after birth
also encourage flu vaccine

41
Q

teratogenic substances

A

-meds **(no med is 100% safe)
-tobacco
-alcohol
-caffeine
-marijuana
-cocaine

42
Q

when do medications pose the greatest to the fetus

A

1st trimester d/t organ development

43
Q

affects of tobacco during pregnancy

A

-low birth wt
-preterm birth
-prom
-fetal demise
-placenta previa
-abruptio placenta
most mothers will go back to smoking so try best to get them to fully stop or reduce

44
Q

affects of alcohol during pregnancy

A

-fetal alcohol syndrome
-increased risk of miscarriage
-IUFD (stillbirth)
-lower birth wt

45
Q

fetal alcohol syndrome characteristics

A

-growth retardation
-facial anomalies
-mental retardation

46
Q

affects of caffeine during pregnancy

A

hypersensitivity in newborn phase jittery baby w/ caffeine w/draw

47
Q

what should you limit your caffeine to in pregnancy

A

200mg/d
-cup of coffee = 100
-12oz soda or tea = 50

48
Q

affects of marijuana during pregnancy

A

little to no research but gateway drug

49
Q

affects of cocaine during pregnancy

A

-potential for maternal MI, cardiac arrhythmias, ruptured aorta, seizure, stroke
-abruptio placenta, PROM, low birth wt, SIDS, CHD, limb defects

50
Q

how can you test for cocaine uses during pregnancy

A

after birth sample the cord
urine screening can only detect for 24-48hrs after use

51
Q

what is women concerned advanced maternal age

A

35

52
Q

special concerns of expectant couples over age of 35

A

-do they have enough energy to care for the baby
-ability to deal w/ needs of child as they age
-social: only couple having first baby

53
Q

ways to help avoid adolescent pregnancy

A

provide education and resources
keep them busy & enroll in after school activities

54
Q

physiologic risks w/ adolescent pregnancy

A

-preterm & LBW
-pre eclampsia
-iron def anemia
-cephalopelvic disproportion
-use of alc & drugs during
-STIs

55
Q

role of L&D nurse during adolescent labor

A

-sustain a presence w/ them and create trust
-education about choices
-help people find their roles
make teen aware they have full medical attorney of power

56
Q

risks associated w/ obesity in pregnancy

A

-spontaneous abortion
-GDM
-PreEclamp
-labor induction
-C section
-fetal anomalies
child is at greater risk for becoming obese

57
Q

how much fluid per day and of that how much water

A

8-10 8oz glasses of fluid (4-6 being water)
total 64-80 oz/d

58
Q

what can an ultrasound show us

A

anomalies, neural tube deficits, skeletal malformations

59
Q

nuchal translucency testing

A

-can do starting at 11wks to test for trisomy disorders by ultrasound
-measurements of 33mm+ are at risk
-detects 70-80% of downs does not dx

60
Q

transvaginal ultrasound

A

clearer images d/t proximity and can be a great predictor of preterm birth since it can measure cervical length (short = preterm) and funneling (cone = preterm)

61
Q

ultrasound doppler blood flow studies

A

noninvasive US test which measures blood flow changes in maternal and fetal circulation during 2nd & 3rd tri
>95%ile for GA are abnormal

62
Q

nonstress test

A

fetal monitor to assess contractions, fetal heartbeat, and uterine activity

63
Q

what does accelerations with movement or contractions show

A

adequate oxygenation and intact fetal CNS

64
Q

when do we conclude a nonstress test is reactive

A

when we have at least two accelerations in a 20 minute time period if the baby is 32 wks or greater
if <32 then acels need to be 10 beats above baseline for 10 secs vs the 15 & 15 for >32

65
Q

what could cause a nonreactive non stress test

A

-baby in sleep cycle
-affect of medication given

66
Q

unsatisfactory nonstress test

A

data cannot be interpreted or there was inadequate fetal activity

67
Q

what are the categories in a BPP

A

1) fetal breathing movements
2) gross body movements
3)fetal tone
4)amniotic fluid volume
either normal and get 2pts per category or abnormal and get 0pts
+non stress: if normal can get an additional 2 pts

68
Q

if a baby does not score an 8/8 on the BPP, what is the follow up care

A

perform a non stress test to determine if baby is having good fetal movement & has an intact CNS

69
Q

what does a contraction stress test evaluate

A

oxygenation and CO2 exchange of placenta
-w/ contractions, intrauterine pressure increases and blood flow (+ O2) decreases to fetal
if placental insufficiency, a decrease in FHR will occur (late decels)

70
Q

desires results of a contraction test

A

negative
in a 10 minute period, we should see there is no drops in the heart rate of late decels meaning baby had good O2 reserve for that time of stress

71
Q

what does a positive contraction test mean

A

during the contractions in a 10 minute time, baby was having late decels

72
Q

amniocentesis

A

test amniotic fluid for fetal abnormalities and fetal lung maturity
L/S ratio of 2:1 = mature lungs

73
Q

chorionic villus sampling considerations

A

it is done early but has risks for bleeding, ROM, infection, limb reduction & birth defect and the results won’t be conclusive and they will take awhile to obtain

ABSN (145 decks)

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