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ABSN Cohort 19 > OB Exam2 > Flashcards

OB Exam2 Flashcards

1
Q

2 Origins of Pain

A

Visceral - uterine/cervical radiation

Somatic -perineal tissue intense/sharp

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2
Q

Dick-read Preperation

A

deep to shallow, sustained pushing, breath holding

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3
Q

Lamaze Preparation

A

psychprophylactic PPM - mind control

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4
Q

Bradley Preparation

A

partner coached

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5
Q

Birthing from within, Hypnobirthing, professional association

A

Foster confidence!

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6
Q

Gate-Control Method

A

Only so much sense can go through nerve, other senses block pain

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7
Q

Local Perineal block is for…?

A

suturing lacerations

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8
Q

Pudendal block is for…? when?

A

supporting forcep/vacuum, 2nd - 3rd stage

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9
Q

Spinal block location and 3 ▲

A

L3 - L4

▲ HypoTN, breathing pattern, placental perfusion

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10
Q

Headache r/t block?

A

Use Blood patch to stop leak of fluid

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11
Q

Epidural block location

A

↓ L5

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12
Q

CSE - aka walking

A

Combo of opiod/analgesia

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13
Q

Naloxone

A

Counter to opiods if pt has respiratory depression

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14
Q

External/Internal FHR monitoring

A

Toco/Doppler - Intrauterine Pressure Cath and Fetal Spiral Electrode

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15
Q

FHR averages

A

Norm 110 - 160
Tach ↑ 160
Brad ↓ 110

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16
Q

FHR Variabilities (4)

A 
Absent = 0 ▲ r/t baseline
Minimal = ↑↓ 5
Moderate = ↑↓ 6 - 25
Marked = ↑ 25
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17
Q

Tracings (6)

A

Normal = Ø ▲ w/ contractions
Tach = ↑ 160 / 10 min
Brad = ↓ 110 / 10 min
Acceleration ↑ by 15 / 15 sec but ↓ 2 min (32: 10 / 10 sec)
Tachystole ↑ 5 UC / 10 min
Deceleration ↓ FHR with Nadir. ↓30s=cord ↑30s=head

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18
Q

Intensity Contractions FACE MODEL (4)

A

Mild = tip of nose
Moderate = chin
Firm = forehead
Resting - SOFT

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19
Q

Categories I, II, III

A 
I = no action req.
II = abnormal, evaluate
III = one of the Tracings, resusictative measures
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20
Q

Resuscitative Measures (4)

A

Turn laterally, change pos, fluids, O2

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21
Q

Labor begins and ends when…?

A

First contraction, begin attachment with infant

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22
Q

First Stage starts…? 3 stages.

A

Regular uterine contractions
Latent = 3cm
Active = 4 - 7cm
Transition = 8 - 10cm

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23
Q

Second Stage starts…? 3 stages.

A

Full dilation and complete effacement (100%, 10cm, x)
Latent = passive decent
Descent = active push
Transition = pushing most effective

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24
Q

Third Stage what drops…?

A

Placenta in 15 - 20 minutes

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25
Q

Fourth Stage bis all about (2)…?

A

Recovery and transition

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26
Q

Nullip vs. Multip when birthing?

A

Nullip slower than multip (50/30min)

27
Q

Ritgen Maneuver

A

Push up from bottom, grab head

28
Q

Nuchal Cord

A

Cord is around neck

29
Q

2 Types episiotomies and repair process

A

Mediolateral
Medial
dissolvable suture w/ local anesthetic

30
Q

Birthing Care interventions (4)

A 
Warm shower/compress for pain
Cool cloth for face
Urinate often - bladder
Ice ships - bowel fx
Ambulate
31
Q

Reccurent Decelerations require…?

A

Fluid bolus (SLAM the bag, no pump)

32
Q

PP: Post-Partum heal times (vaginal vs. C-section)

A

6 weeks vs. 8 weeks

33
Q

PP: Linea Negra/Straie

A

fade w/ tie, sometimes permanent

34
Q

PP: Uterus (3 possibilities)

A

Involution (1 -2cm q24hr, done in 2 weeks)
Subinvoution (failure b/c fragments/infx)
Inversion (it’s OUT! Nurse put back in)

35
Q

PP: Contractions AKA + what equalizes and how + hormone?

A

After Pains
Hemostasis via blood vessel compression via contractions
Oxytocin via pituitary coodinates

36
Q

PP: Lochia (3 and time), Bleeding =?

A 
Rubra = red 3 - 4 days
Serosa = clearish 22 - 27 days
Alba = whitish 10 days - 6 weeks
Bleeding = period
37
Q

PP: Cervix state and time to regain shape

A

Soft, regains overs 12 - 18 hrs

38
Q

PP: Vagina/Perinum. Hormone and ▲

A

↓ Estrogen = thinness, dryness, painful sex

Decreases in size but NEVER the same again!

39
Q

NO SEX FOR HOW LONG?!

A

5 - 6 weeks

40
Q

PP: Introitus (Vaginal Opening), state, episiostomy heal time, hemorrhoid heal time, what to eat.

A

swollen/erythematous.
Episio = 2 - 3 weeks
Hemorrs = 6 weeks

↑ fiber, prenatal vits

41
Q

PP: Pelvic Muscles heal time, possible problem?

A

6 months, do Kegels!

Pelvix relaxation = muscles relax and organs drop into vaginal space

42
Q

PP: Placental Hormones

A

DROP in everything to reverse effects of pregnancy

43
Q

PP: Abdomen

A

Relaxed 2 weeks

Return to non-prego in 6 weeks

44
Q

PP: BOOB function

A

All in the stimulation

Should feed 10-12x a day q2hr

45
Q

PP: Urinary

A

Diuresis/Diaphoreis 12hrs/2-3days

46
Q

PP: GI

A

Very hungry, no BM for potentially 2 - 3 days

47
Q

PP: Cardiovascular blood volume ▲ and possible issue

A

Blood volume ↓ / 2 weeks and normal by 6 months.
THIS IS OK cause they’re hypervolemic during pregnancy

Cardiac output SAME for 48 hrs/elevated 12 weeks
↑ coagulability and immobility r/in thromboembolism.

48
Q

PP: Neurologic ▲. Shaking? and time to normal.

A

Shaking is normal.

Discomforts (like carpal tunnel) should go away in 6 - 8 weeks unless prexisting

49
Q

PP: Headaches?! Due to? Tx with?

A

cerebrospinal leak into extradural space

Otologist blood patch

50
Q

PP: VS rounds and expectation.

A 
Q15min x4
Q30min x2
Q1hr x 2
Q4-8hrs
Should be stable unless HTN/Preclampic
51
Q

Rubella Vaccine - sex lockout

A

3 months

52
Q

Rogam given if…? time window to give? route?

A

Mom Rh+ Baby Rh-. Give within 72 hrs post-partum IM

53
Q

PP: MusculoSkeletal heal time and shoe size?

A

6 - 8 weeks, ↑ shoe size 2

54
Q 
PP: Integumentary
Chloasma
Areolae/Linea Nega
Vascular Abnormalities are b/c
Spider Nevi, which hairs stay?
A

mask fades by end of pregnancy
Hyperpigmentation that fades
decline with declining estrogens
FOREVER, fine hair leaves, coarse stays

55
Q

Care of Family - Nursing Role

A

Faciliate transition

56
Q

Family Care 4 Educations

A

Prevent infx
Prevent excessive bleeding
Maintenance of uterine tone
Prevention of bladder distention

57
Q

Emergency Treatment vs. Newborn Protection

A

Hospital MUST help laboring lady

By LAW must stay 2 days if VAG. Delivery, exceptions with multips

58
Q

Estrogen FX on milk production

A

↓

59
Q

Tub Bathing/hot tubbing?

A

NOPE!

60
Q

Baby immunizations times (5)

A

2 mo, 4 mo, 6 mo, 1 year, 15 mo

61
Q

Family Care Vaccinations and Routes (3)

A

Rubella SubQ lateral arm
Varicella SubQ
TDaP IM (10 years)

62
Q

When to initiate breastfeeding

A

when baby is MOST ALERT 3- 4 hours post birth

63
Q

BIG UTERUS + BREASTFEEDING = ???

A

PAIN!!!

64
Q

4 Reasons for ▲ in PP discharge

A

Consumer demand
Medical necessity
Discharge criteria for lowrisk childbirth
Cost-containment measures

ABSN Cohort 19 (28 decks)

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