Ob Final Flashcards
Cholasma
Brown or gray patches on face
Linea Nigra
Dark vertical line that appears on abdomen
Striae Gravidarum
Stretch marks
What to do if a pregnant woman is experiencing nausea and vomiting
Educated about crackers by the bed, having frequent small meals, avoid trigger smells
Fundo height
Each centimeter is one week of pregnancy
Fetal movement counting
Count to 10 method:
10 distinct movements in 1 to 2 hours is the desired result
Patient comes in and hasn’t felt baby moving in a while. What do we do?
Non-stress test
Non-stress test
client pushes a button whenever she feels a fetal movement
Reactive equals 2+ accelerations in 20 minutes
Non-reactive is fewer than two in 40 minutes
Red flags to monitor for
Swelling of hands, face, legs, or tingling
Ankles is normal
Visual changes
Severe belly pain
Headaches that worsen (preeclampsia)
Rapid weight gain 5+ pounds in a week
Baby not moving
GTPAL
G - # of pregnancies
T - term >37 weeks
P - preterm < 37 weeks
A - abortion <20 weeks
L - living children
Nagels rule
Subtract 3 months
Add 7 days
Amniocentesis
Aspiration of amniotic fluid:
Monitor vital signs during and 30 minutes after
Obtain baseline prior
Empty the bladder prior to procedure
Administer RHD immune globulin to the client if they are Rh NEGATIVE
Biophysical profile (BPP)
Combines a non-stress test with an ultrasound
What does the BPP assess?
FHR
Fetal breathing
Fetal body movements
Fetal tone
amount of amniotic fluid
BPP results
8-10 = normal
<6 ABNORMAL
Abruption expected findings
Board like abdomen
Dark red vaginal bleeding
uterine tenderness
sudden onset of intense localized pain
Abruption
Separ ation of the placenta from the uterus
Occurs after 20 weeks gestation
Leading cause of maternal death
What is the only management of abruption?
Delivery
Cervical insufficiency treatment
Cerclage
Cerclage
Cervix “stitched”
Bestest and no sex
Prevent premature birth
Do not insert anything into vagina
Keep bladder empty
Ectopic pregnancy
Abnormal implantation of the ovum outside of the uterine cavity
Ectopic pregnancy findings
Unilateral stabbing pain
scant dark red or brown vaginal spotting
referred shoulder pain
Severe shoulder pain and ectopic pregnancy indicates what?
Ectopic rupture
ectopic pregnancy DX & TX
Transvaginal ultrasound that shows an empty uterus
Rapid treatment
Methotrexate dissolves the pregnancy
Salpingostomy if not ruptured
Laparoscopic salpingectomy if ruptured
Removes the tube
What is methotrexate used for in ectopic pregnancies?
Gestational diabetes causes an increase risk to the fetus …
Macrosomia (big baby)
Birth trauma
Electrolyte balances
HYPOGLYCEMIA
Gestational diabetes percentage
50% of clients diagnosed with gestational diabetes mitis will develop type two DM later in life
Pre-eclampsia
hypertension and protein in the urine
(140/90)
Severe preeclampsia
Hypertension (160/110)
3+ proteinuria, severe headaches, epigastric, and RUQ pain
Eclampsia
Severe pre-eclampsia plus onset of seizure, activity or coma
HELLP syndrome
Hyperemesis gravidarum
Extreme, severe nausea, vomiting that doesn’t go away
Hyperemesis gravidarum medication’s
Lactated ringers
Vitamin B6
Antiemetic (metoclopramide)
Magnesium sulfate
Treats HELLP syndrome
Anti-convulsant used prophylactically to prevent seizures
Manifestations of magnesium sulfate toxicity
Absence of deep tendon reflexes
Urine output less than 30
Respirations less than 12
Delayed level of consciousness
Cardiac dysrhythmias
What to do if magnesium sulfate toxicity is suspected
Stop being infusion
administer antidote: calcium gluconate
Spontaneous abortion
Pregnancy ends as a result of natural causes
Use the term miscarriage
Preterm labor meds (tocolytics)
Magnesium sulfate
Turbutaline
Indomethacin (NSAID)
Betamethasone
Magnesium sulfate for preterm labor
Suppresses contractions and inhibits uterine activity
Mag sulfate contraindications
Dilation greater than 6 cm
Chorioamnionitis
Greater than 34 weeks gestation
Acute fetal distress
Do not use concurrently with amphetamine
Indomethacin for preterm labor
Suppresses preterm labor by blocking production of prostaglandins
Monitor for hemorrhage due to reduce plate aggression
Betamethasone
Enhances fetal lung maturity and surfactant production
IM in 2 injections 24 hours apart
First stage of labor (0-10)
Latent - 0-3 cm
Active - 4-7 cm
transition - 8-10 cm
Second stage
Assist with pushing efforts
Monitor fetal heart rate rate
Prepare for immediate newborn care
Third stage
Delivery of placenta
Assessment
Comfort care
Fourth stage
Stabilizing/bonding
Vital signs skin to skin breast-feeding
True labor signs
Bloody show
Pain and lower back
Contractions that increase when walking
Presenting part of infant engages
CERVICAL CHANGEEE
False labor
Irregular contractions improved with walking
Pain felt and abdomen or no pain
Changes in dilation
NOOO bloody show
Dilation
Opening of the cervix measured in CM
0-10
Effacement
Processed by which the cervix thins shortens and softens in preparation for birth
Station
The position of the babies presenting part in the mothers pelvis
Normal fetal heart rate
110 to 160 BPM
VEAL CHOP MINE **
V + C + M
Variable decelerations
Cord compression
Maternal reposition
E + H + I
Early decelerations
Head compression
identify labor progress
A + O + N
Acceleration
OK
no intervention
L + P + E
Late deceleration
Placental insufficiency
Execute interventions - change position
Best way to keep baby warm
Skin to skin Thermo regulation
