Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > OB Exam 3 Pt 2 > Flashcards

OB Exam 3 Pt 2 Flashcards

1
Q

Of all pregnant women treated for depression, what proportion of them has a first occurrence during pregnancy?

A

1/3 Pg. 757.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

According to the nurse alert in the first part of the chapter, what are three critical cues in identifying depression in pregnant women?

A

Psychological symptoms, a suicide plan, major disruptions in sleep patterns. Pg. 758

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which medication for coughing, if taken with an SSRI can cause serotonin syndrome to develop?

A

Dextromorphan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which physical birth defects do benzodiazepines cause?

A

Cleft lip and palate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the greatest single preventable cause of mental retardation?

A

Prenatal alcohol exposure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which illicit drugs may cause placental abruption?

A

Cocaine and methamphetamines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are signs and symptoms of postpartum depression?

A

Fear, anxiety, despondency, irritability, jealousy, and difficulty falling asleep and returning to sleep when awakened.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A woman has PP psychosis and wants to breastfeed. What medication considerations should clinicians and pharmacists consider?

A

Medications with greater documentation of prior use, lower FDA risk category, few or no metabolites, and fewer side effects. Pg. 775.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the medication category of choice for the treatment of PP onset of anxiety dosorders?

A

SSRIs Pg. 776.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Despite the advanced technology and specialized care available to American women, are there some birth injuries that are simply unavoidable?

A

Yes, that is true. Pg. 837.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some maternal factors that predispose an infant to birth injuries? See page 838.

A

Maternal age and gravidity status, uterine dysfunction such as prolonged or precipitate labor, preterm or postterm labor, CPD (cephalopelvic disproportion)..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List some fetal factors that predispose the fetus to birth injuries.

A

Fetal macrosomia, multifetal gestation, abnormal or difficult presentation, congenital anomalies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which is the bone most commonly fractured during birth?

A

The clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which is the most common type of paralysis associated with a difficult birth?

A

Erb-Duchenne palsy, or brachial plexus injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What percentage of infants born to mothers with diabetes is at risk for complications?

A

All infants of mothers with diabetes are at some risk for complications. Pg. 841

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What may be the mortality rate of unborn babies resulting from one episode of maternal ketoacidosis?

A

50% or more.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Excessive shoulder size in macrosomic infants may lead to which birth problem?

A

Dystocia (often shoulder dystocia, specifically) Pg. 843.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Blood glucose levels less than ____ mg/dl are considered hypoglycemic in term infants. (This is important and that is why I have asked it more than once in this class.)

A

40 mg/dl. (Other places in the book say 40 – 50).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In which sort of infant is hypoglycemia most common?

A

The macrosomic or LGA baby, also preterm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hypocalcemia and hypomagnesaemia have been reported to occur in what percentage of infants of diabetic mothers?

A

50%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Are infants of diabetic mothers at increased or decreased risk of developing hyperbilirubinemia and polycythemia?

A

Increased risk..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is the amount of hemoglobin in the tissue from bruising (and even in cephalhematomas) enough to cause high bilirubin levels in neonates?

A

Yes it is!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

“P________, the most common form of neonatal infection, is one of the leading causes of perinatal death and is caused by many of the same organisms that cause sepsis.” (Pg. 846)

A

Pneumonia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

You have heard this before, but which intervention by healthcare providers has been demonstrated to prevent nosocomial infection in nurseries?

A

Effective handwashing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Though cats are the definitive host of toxoplasmosis, in which other common animals is it found? (In our state with extensive farming, this is important.)

A

Dogs, pigs, sheep and cattle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mothers with HIV who take all precautions such as HAART, and have elective cesarean sections can reduce the risk of perinatal transmission to the baby to the rate of approximately 1%. What is the risk if no precautions or treatment is given? The risk if the mother breastfeeds?

A

12 – 40%; 1/3 to 1/2. Pg. 850.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Should HIV exposed infants be given the usual vaccinations?

A

Yes they should.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which infection is the leading cause of neonatal morbidity and mortality in the US?

A

Group B streptococcus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the source of neonatal exposure to E.Coli?

A

Maternal birth canal and rectum, also from the hospital environment.

30
Q

What is the major source of colonization by S. aureus in the hospital?

A

The hands of medical and nursing personnel. Pg. 854.

31
Q

An infant has a yellow discoloration of the sclera and mucus membranes of the head and face. What is the correct term for this?

A

Jaundice or icterus.

32
Q

Pathologic jaundice or hyperbilirubinemia is the level of serum bilirubin that left untreated can result in acute _______ _________ or kernicterus.

A

Bilirubin encephalopathy.

33
Q

Bilirubin encephalopathy describes acute manifestations of hyperbilirubinemia. Which term describes the chronic and permanent results of bilirubin toxicity?

A

Kernicterus. Pg. 868

34
Q

What is the mechanism of action of RhoGAM, i.e., how does it work?

A

“The injection of anti-Rh antibodies destroys any fetal RBCs in the maternal circulation and blocks the maternal antibody production.” Pg. 870.

35
Q

When should RhoGAM be given to the Rh negative pregnant/perinatal woman?

A

At 28 weeks of pregnancy, within 72 hours after delivery, after an invasive procedure or any time there is risk of fetal blood entering mom’s circulation—like after an auto accident. (Note: PP RhoGAM prevents mom from producing antibodies to the fetal blood cells that entered her bloodstream during birth– thus, it protects the next pregnancy.)

36
Q

What is the major cause of deaths in the US among infants younger than 1 year of age?

A

Major congenital defects

37
Q

Which is the most common congenital heart defect and cyanotic lesion? The most common acyanotic disorder?

A

VSD; Tetralogy of Fallot.

38
Q

When during gestation is the critical time period for cardiovascular development?

A

3 – 8 weeks of gestation, when many women are not aware that they are pregnant.

39
Q

What signs and symptoms of a cardiac anomaly might the nursery nurse see in a neonate? (See the study guide and book on this.)

A

Cyanosis (central, and often unrelieved by O2), paleness, mottling on exertion, restlessness, lethargy, brady or tachycardia, abnormal heart rhythms, murmurs. Tachypnea, sternal or costal retractions, nasal flaring, grunting, dyspnea. Pg.875 and my study guide.

40
Q

List the causes given in your textbook for neural tube defects (NTDs).

A

Ingestions of valproic acid, methotrexate, excessive maternal heat (febrile or hot tub), maternal folic acid deficit and low s/e class. Pg. 876.

41
Q

In which positions will the nursery nurse place the place the infant with a myelomeningocele?

A

Prone-kneeling.

42
Q

With which sort of dressing will a myelomeningocele be covered?

A

Sterile, moist non-adhering dressing, (without latex, incidentally, though this edition of the book does not mention this). Pg. 877.

43
Q

What is choanal atresia? What is the treatment for it?

A

A bony or membranous septum located between the nose and pharynx originating as a laryngeal web. Perforating the web by emergency surgery.

44
Q

When is repair of cleft lip usually done? Cleft palate?

A

6 – 12 weeks or when the infant reaches 3600 – 4000 gms; 1 – 2 years of age.

45
Q

What is a common maternal finding in a pregnant woman whose fetus has esophageal atresia or tracheoesophageal fistula?

A

Maternal Polyhydramnios.

46
Q

Which signs and symptoms will the nurse notice in the infant with esophageal atresia or tracheoesophageal fistula?

A

Excessive oral secretions, drooling, feeding intolerance, coughing and gagging when taking anything orally, leading to choking and respiratory distress in some cases.

47
Q

Meconium ileus is caused by meconium impacted in the intestines. It is a sign of which chronic illness in over 90% of cases?

A

Cystic fibrosis.

48
Q

Which device is used to treat congenital hip dysplasia (developmental dysplasia of the hip), with an 80 % success rate? (This is often on standardized tests).

A

Pavlik harness.

49
Q

With which medical intervention for clubfoot will the nurse be instrumental in assisting with, and in doing parental teaching before the patient is discharged from the nursery?

A

Serial casting.

50
Q

Polydactyly is common—at least one student nearly always sees it in clinical. How is it treated if there is no bone present in the digit?

A

Tied with suture and allowed to fall off.

51
Q

Which is the most common anomaly of the penis?

A

Hypospadias.

52
Q

Why are infants with hypospadias not circumcised?

A

The foreskin may be needed for surgical repair. Pg. 887.

53
Q

What is periodic breathing?

A

The breathing exhibits 10 – 15 second pauses, followed by 10 – 15 seconds of compensatory rapid respirations. Pg. 896.

54
Q

Which factors cause increased risk for neonates to be susceptible to RDS?

A

Perinatal asphyxia, hypovolemia, male gender, Caucasian race, maternal DM, second twin, family predisposition, maternal hypotension, C/S without labor, hydrops fetalis and third trimester bleeding. Pg. 915.

55
Q

What is the cause of RDS?

A

Lack of pulmonary surfactant.

56
Q

Simply not making sufficient surfactant is one cause of having insufficient amounts. But there are others. What are they?

A

Abnormal composition and function, disruption of production or a combination of factors. Pg. 915.

57
Q

Like a snowball rolling downhill, once the RDS cascade begins, it can grow with a great deal of speed. Pulmonary vascular resistance can exacerbate to the point in which pressure on the right side of the heart increases, resulting in right-to-left shunting. How might this affect the fetal structures of the heart?

A

It could reopen the foramen ovale and ductus arteriosis.

58
Q

RDS is said to be self-limiting and decreases after 72 hours. What occurs to make that so?

A

Because of production of surfactant in the type 2 cells of the alveoli.

59
Q

List the support and treatment modalities for RDS.

A

Positive pressure ventilation, bubble CPAP, oxygen therapy, exogenous surfactant.

60
Q

Which nursing care interventions are used for infants with intraventricular hemorrhage?

A

Interventions to decrease risk of bleeding and supportive care; Head in midline position, HOB elevated slightly, avoid rapid IV infusions, monitor B/P and avoiding or minimizing activities that increase cerebral blood flow. Swaddle or comfort for painful procedures. Pg. 917.

61
Q

Perinatal asphyxia is one cause of NEC. Name the other two other conditions associated with NEC.

NEC = Necrotizing EnteroColitis

A

Colonization with harmful bacteria and enteral feeding Pg. 918.

62
Q

What seems to have a protective effect NEC?

A

Breastfeeding.

63
Q

How long after birth does NEC usually manifest in term and preterm infants?

A

Typically 1 – 3 days after birth for term; within 7 days for preterm.

64
Q

The gastrointestinal signs and symptoms of NEC are:

A

Abdominal distension, bile-stained gastric aspirate, vomiting bile or blood, grossly bloody stools, abdominal tenderness and erythema of the abdominal wall.

65
Q

What is the cause of the air in the bowels and abdomen that is seen on X-rays of the abdomen?

A

Gases produced by bacteria invading the intestinal walls.

66
Q

What treatments are used for NEC?

A

NPO, O/G tube to suction, parenteral nutrition, control infection with handwashing, antibiotics, and surgical resection if needed.

67
Q

What is grief?

A

Many answers are appropriate here, one is found on page 932, 10th ed. : it is the painful emotions and related behavioral and physical responses to a major loss. It is of a dynamic nature and very individual. See page 1091, 9th ed

68
Q

What are three phases of grief listed in your book?

A

Acute distress, intense grief, reorganization.

69
Q

Should children be informed of the death of the sibling?

A

Usually it is recommended since they will sense that something is wrong and, not understanding what the problem really is, may blame themselves.

70
Q

How should the nurse treat the dead baby when bringing it to the parents and handling it?

A

Just as they would a live baby.

71
Q

How are the physical needs of a postpartum bereaved mother different from a non-bereaved mother?

A

The mother is still postpartum so has the same physical needs; yet will have no baby to nurse and will still have afterpains and the typical PP changes. Pg. 943

72
Q

When should grieving parents be referred to counseling?

A

When they show signs of complicated grief or posttraumatic stress. Pg. 948

OB (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions