oB exam 3 Flashcards by sadie cook

> 3mm could indicate genetic disorder on what scan

nuchal translucency scan

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when can an amniocentesis be performed

after 14wks

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excessive amniotic fluid

polyhydramnios

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cause: unknown, may be r/t DM or twin-to-twin infusion

polyhydramnios

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decreased amniotic fluid that may be caused by fetal anomalies or PROM
- fetal anomolies associated w/ poor kidney function, PROM

oligohydramnios

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tx oligohydramnios

amnioinfusion or LR into amniotic sac

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T/F: obesity decreases ability for mother to sense fetal movements/kicks

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includes NST, fetal breathing movement, fetal muscle tone, amniotic fluid volume

biophysical profil (BPP)

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2 eggs fertilized, fraternal twins

dizygotic

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one egg fertilized & then split into 2, identical twins

monozygotic

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unusually acute nausea & vomiting

hyperemesis gravidum

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what can hyperemesis gravidum lead to?

malnutrition, electrolyte imbalances, wt loss

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occurs before 20wks GA
normally result of chromosomal abnormalities
evaluate for bleeding, cramping, passage of tissue

spontaneous abortion

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pregnancy occurring outside of uterus, most commonly the fallopian tube

ectopic pregnancy

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what is a possible complication if an ectopic pregnancy isnt treated?

fallopian tube rupture

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what to do with a suspected miscarriage

watchful waiting

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this med stops cell division, tx for ectopic pregnancy

methotrexate

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HTN &/or stable/pre-existing proteinuria prior to 20wks GA & persisting after 12wks PP

chronic HTN

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development of preeclampsia or eclampsia in pt w/ chronic HTN

superimposed preeclampsia or eclampsia

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systolic BP >140 &/or diastolic BP 90+ without proteinuria or s/s end-organ dysfunction after 20wks GA

gestational HTN

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development of convulsions or coma in preeclamptic pt

eclampsia

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this medication lowers seizure threshold, tx preeclampsia; reduces CNS irritability caused by cerebral edema

magnesium sulfate

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140/90mmHg+ on 2 occassions at least 4h apart & proteinuria OR other organs effected

preeclampsia

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during seizure:

tun on side (aspiration), O2 admin

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- severe headache that won't go away w/ meds - swelling of face/hands - wt gain 2lb+ in 1 wk - difficulty breathing, gasping, panting - nausea after mid-pregnancy - changes in vision - RUQ abdominal pain/shoulder pain - increased DTR

preeclampsia s/s

want serum mg to be:

4-7

mag reversal agent

calcium gluconate

HELLP syndrome

hemolysis, elevated liver enzymes, low platelets

GDM

maternal body not able to keep up with demands

when do you screen for GDm?

24-28wks

if BG is over _____, further testing is indicated

130

DM diagnosed during pregnancy & diet controlled

DM diagnosed during pregnancy requiring medication

if a GDm pt is getting a c-section, can she take her AM insulin?

how does the baby react to DKA?

metabolic acidosis, death

what disease can be transferred to fetus?

herpes

tx of syphilis

penicillin G

may block birth canal, vaccine available

HPV

tx trichomonas

flagyl

painless, premature dilation of cervix in 2nd trimester pregnancy in absence of contractions

cervical insufficiency

tx cervical insufficiency

maternal progesterone, cervical cerclage

cervical canal narrowed after suture placement, must unstitch around 36wks; labor often soon after removal

cervical cerclage

use this to minimize maternal supine hypotension

wedge

where do you perform CPR on pregnant client

higher on chest

normal bacteria that can colonize in vagina, asymptomatic mom

GBS

when do your get swabbed for GBS

35-37wks

how would baby get exposed to GBS in labor?

while coming down vaginal canal

want to delivery baby within ___ hr PROM

promote lung maturity, prevent brain bleed, prevent necrotizing enterocolitis, prevent neonatal death

corticosteroids

these drugs kill contractions

tocolytics

tocolytics may be used for ____ hrs to allow for full course corticosteroids admin

give corticosteroids ___x 24h apart to prevent baby from having problems

this specific medication is given maternally for fetal lung development - not used after 34wks

betamethasone

when treating preterm labor, what medication can be given to extend pregnancy?

progesterone

this medication can help protect fetus from cerebral palsy

magnesium sulfate

infection of amnion, chorion, or both

chorioamnionitis

s/s: - EFM tachycardia - fould smelling discharge - elevated WBC - FEVER

chorio

- admin vaginally or orally - CI women previous c-section due to risk of uterine rupture - monitor for uterine tachysystole - cervical ripening agent

misoprostol

- causes release of own prostaglandins to mechanically ripen cervix

balloon catheter

dosing oxytocin

1mu/min = 1mL/h

placental tissues overlies the internal cervical os (cervical opening) - placenta attached ot where opening is

placenta previa

what type of bleeding is placenta previa associated with?

bright red vaginal bleeding

T/F: vaginal delivery is indicated for placenta previa

premature detachment of placenta from uterine lining, mild or severe

placental abruption

- dark red bleeding - knife-like pain - uterine tenderness - contractions - hard/rigid uterine tone - decreased fetal movement/activity

placental abruption

pathologic activation clotting cascade resulting simultaneously in blood clots, platelets & clotting factor depletion, therefore bleeding

DIC

contractions happen in middle of uterus, causing no downward pressure (non-laboring contractions)

hypertonic

weak contractions w/ not enough power

hypotonic

too many contractions

tachysystole

interventions for ineffective pushing

laboring down, allow rest before 2nd stage, educate & encourage

labor lastig <3h

precipitous labor

maternal pelvis smaller than body

cephalopelvic disproportion

baby head is stuck halfway out, unable to be oxygenated

turtle sign

hyperflexion of hip to bring knees back toward laboring woman

mcrobert's maneuver

woman moved onto hands & knees

gaskin maneuver

downward pressure just above pubic bone in an attempt to rotate anterior shoulder

suprapubic pressure

aid fetal descent & delivery

forceps-assisted birth

used in someone w/ cardiac disease who cannot push, baby is in distress

forceps-assisted delivery

- lower maternal injury than forceps, risky to neonate - only can have 2x popoffs

vacuum-assisted delivery

trial of labor after c-section

TOLAC

- sudden category II or III FHR - fetal station change - weakening CTXs - abdominal pain - vaginal bleeding - hematuria

uterine rupture

tx prolapsed cord

presenting part held off cord until can get c-section

amniotic fluid enters maternal circulation

amniotic fluid embolism

- dyspnea - cyanosis - tachycardia - shock - seizures - hypotension - DIC

amniotic fluid embolism