OB Final Flashcards
What is the difference between the cervix prior and post birth?
cervix prior birth is small, regular, oval opening
cervix post birth has a transverse slit that resembles lips
What is the most inexpensive way to prevent clots?
ambulation
What is the “hormone of pregnancy”/ sustain pregnancy?
progesterone
What is the most common cause of hemorrhage?
uterine atony in the 4th stage of labor
What is a way to promote bonding after birth?
give the baby to the mother immediately after birth
What is a big risk for infection during pregnancy?
multiple hands in the vagina
What is conduction?
transfer of heat from one object to another when the two objects are in direct contact with each other
- cold mattress, scale, circumcision board
What is convection?
flow of heat from the body surface to cooler surrounding air or to air circulating over a body surface; breeze from a window being open
- cool breeze that flows over the newborn
- keep away from doors & windows
What is evaporation?
loss of heat when a liquid is converted to a vapor
- when baby is born and covered in amniotic fluid then the air evaporates it
What is radiation?
loss of body heat to cooler, solid surfaces that are in proximity but not in direct contact with the newborn; standing near the closed window; close proximity
Can breast milk be measured?
No, only formula
How often do breast fed babies need to feed?
every 2-3 hours, nursing for 10-20 minutes on each breast
How often do bottle fed babies need to feed?
every 3-4 hours, finishing a bottle in 30 minutes
How much formula should a full term baby be getting?
1.5-2 oz (45-60 mL) per lb
Do newborns drink water?
No, not enough nutrients
What is avoided inside the babies crib?
no toys or clothing inside the crib
What is the first stage of labor?
“dilation”- from the first contraction to the full dilation of the cervix
What is the second stage of labor?
“expulsive stage”- fully dilated cervix and ends with the birth of the newborn
What is the third stage of labor?
“placental expulsion”- newborn is born to the separation/ birth of the placenta
What is the fourth stage of labor?
“restorative stage/ immediate postpartum period”- mother’s body begins to stabilize after the hard work of labor and the loss of the products of conception
What is the longest stage of labor?
first stage “dilation”
What is the latent/early phase?
0-3 cm; 0%-40% effacement; takes 9 hours; contractions are every 5-10 minutes lasting 30-45 seconds
What is the active phase?
4-7 cm; 40%-80% effacement; takes 6 hours; contractions are every 2-5 minutes lasting 45-60 seconds
What is the transition phase?
8-10 cm; 80%-100% effacement; every 1-2 minutes lasting 60-90 seconds
Which PHASE is the most difficult, but shortest?
transition phase
What time period is RhoGAM given?
given at 28-32 gestational weeks and within 72 hours after birth
What is the difference between pudendal block and epidural?
pudendal- usually for 2nd stage, episiotomy, or operative vaginal birth
epidural- continuous infusion or intermittent injection; usually started when dilation >5 cm
What is gestational age?
stage of maturity
When is gestational age determined?
physical assessment done at 2 hours of life
What is the APGAR score?
evaluation of newborn’s physical condition at 1 minute and 5 minute then 10 minute if 5 minute is score of 7 or lower
What does APGAR stand for?
A= appearance (color) P= pulse (heart rate) G= grimace (reflux irritability) A= activity (muscle tone) R= respiratory (respiratory effort)
When do newborns need to urinate?
within 24 hours
The newborn’s blood sugar should be at what?
above 145
How many diapers do newborns go through daily?
6-12 diapers to ensure adequate hydration
What is gestational diabetes?
glucose intolerance with its onset during pregnancy or first detection during pregnancy
When do we screen for gestational diabetes?
at 24-28 weeks
How is oxytocin administered?
piggy back, never given as a bolus
At what gestational week do the organs develop?
8 weeks
What is placenta previa?
bleeding condition that occurs during the last two trimesters of pregnancy; placenta implants over the cervical os
What is abruptio placentae?
separation of the normally located placenta after the 20th week of gestation; prior to birth that leads the hemorrhage
Postterm labor is considered at what gestational week?
over 42 weeks
What is premature rupture of membranes “PROM”?
women beyond 37 weeks’ gestation
What is an important NI for premature rupture of membranes?
no unsterile digital cervical exams until woman is in active labor
What is the purpose of invitro fertilization?
increase ovulation
What is the purpose of contraceptives?
decrease ovulation
Where does fertilization take place?
fallopian tubes
What is follicle stimulating hormone (FSH)?
rises and stimulates the follicle to produce estrogen
Signs/symptoms of mastitis?
warm/hot and hard area
When does the foramen ovale close?
at the first breath
When does the ductus venosus?
cutting the cord
When do we feel the movement of the fetus?
16-20 weeks
When does the uterus come out of the pelvis?
12 weeks (3 months)
At what week is the fetus at the top of umbilicus?
20 weeks
How much weight gain per week/ total pregnancy?
25-35 lbs total pregnancy
3-5 lbs total in the 1st trimester, than 1 lb/week until birth
What is the difference between frequency and duration?
frequency- how often the contractions occur
duration- how long a contraction lasts
Difference between morning sickness and hyperactiva gravida?
hyperactiva gravida continues into the 2nd trimester
What does a frank breech baby look like?
feet to head
Common cause of late deceleration?
cord compression
Time frame for postpartum blues?
peak 3-4 days, resolving by day 8
Difference between preterm and postterm babies?
preterm- more vernix caseosa, more hair
postterm- cord dries up, creases on foot
Normal magnesium level? When is it toxic?
4-7 normal
>8 is toxic
What should women with nipple pain do?
breast milk on their nipples and let it air dry
When does menstruation returns for BREAST feeding mother?
3 months- 1 year
When does menstruation returns for BOTTLE feeding mother?
6-8 weeks
What is a nursing implication for an episiotomy?
ice the area
What is the difference between a hematoma and vacuuming (Caput Succedaneum) a newborn?
vacuum will cross the suture line, whereas a hematoma will not
What would be our first indication of a shoulder dysplasia?
listen to hear a click
3 discharge teaching instructions for umbilical cord care?
- do not use alcohol
- let it air dry
- put diaper below umbilical cord
What is going to be bigger, the head or the chest?
the head is about 2 cm bigger than the chest
What are two things we are immediately concerned about after birth?
airway/breathing and thermoregulation
What kind of stool will FORMULA fed babies have?
yellow, yellow-greenish, greenish, loose, pasty, formed, unpleasant odor
*depending on the type of formula
what kind of stool will BREAST feed babies have?
yellow-gold, loose, and stringy to pasty in consistency, sour smelling
What is the difference between HELLP, preeclampsia, and eclampsia?
preeclampsia- treated with magnesium, protein in the urine
eclampsia- seizures
HELLP- no clinical signs, just lab findings
What is uterine inversion and how is it fixed?
uterus turns inside out
fixed with surgery
Before they induce someone, what assessment is done?
bishop score
When is it considered late postpartum hemorrhage?
After 6 weeks.
How does the weight of the baby fluctuate?
In the first week the baby looses about 10% of total body weight. Then the baby starts gaining weight again, and at 6 months the baby should be double birth weight.
What vaccine don’t we give mothers?
TB.
What is subinvolution?
The failure of the uterus to reconstruct after birth leading to hemorrhage.
Can you breastfeed with mastitis?
Yes.
What is the benefit of using oxytocin?
Aids in uterine contractions.
WHY is Rhogam given?
To prevent cell insensitivity.
At what stage are you at greatest risk for hemorrhage?
4th stage.
Whats the difference between 3rd and 4th degree lacerations?
3rd- Tears down through muscle, to the anal sphincter.
4th- Tears through anal sphincter to anus.
What are examples of DIC?
Petechia, bleeding, and bruising.
What is Babinski’s reflex? (Plantar in adults)
Baby’s toes flare up when foot is stroked.
S&S of infant respiratory distress?
Nasal flare, Increased HR, Shivers due to lack of brown fat.
S&S of a women with pulmonary embolism?
SOB, absent lung sounds, tachycardic, weakness, diaphoretic.
What is the favored pelvic shape?
Gynecoid.
