OB Final Review Flashcards
what has the greatest impact in reducing maternal and fetal mortality
antiseptics
What is the term for infection of mothers surrounding labor delivery and post partum
puerperal fever
in the 18th century who attended deliveries and where did they take place
midwife - in home
what was the main factor in swaying women to deliver at hospitals rather than at home
anesthesia
what is primary prevention
teaching to prevent illness, vaccines
what is secondary prevention
health screenings, initial treatment
what is tertiary prevention
rehab, long term treatment for a chronic illness
what is family centered care
care for whole family (parents, siblings, grandparents)
what is a nuclear family
normal
what is a single parent family
mom or dad take care of kids
what is an extended family
family lives together with relatives
what is communal family
multiple families living together
what is a blended family
his, hers, and our kids
what is the primary focus of community based nursing
prevention
what 2 hormones do the ovaries produce
estrogen & progesterone
when does ovulation occur and what hormone stimulates ovulation
12-14 days (menstrual cycle)
LH hormone
where does fertilization normally take place
Fallopian tube
what is the function of the testes
produce sperm
what hormone is produced by the placenta and is used as a positive indicator of pregnancy
HcG
what is the function of amniotic fluid
protection, allow movement, symmetrical growth
what and when are the 3 stages of development from fertilization to birth
pre-embryonic phase - fertilization-implantation (2 weeks)
embryonic phase - implantation - 8 weeks (2-8 weeks)
fetal phase - 8 weeks - birth
when is the developing infant most vulnerable to teratogens
embryonic stage - 1st trimester
what is one of the main first signs of pregnancy
don’t have a period
what nutrient is important to avoid neural tube defects
folic acid
what are braxton hicks contractions
painless contractions - begin 1st trimester
why it is important to take iron supplements during pregnancy
more blood volume - need more iron - hemoglobin production
when is supine hypotension (vena cava syndrome), what are symptoms and treatment for this
woman lies on back (flat) - compresses aorta, venacava, passes out - put mom on left side
when should first fetal movements be felt and what is this called
quickening 16-20 weeks
what are ways to decrease constipation
stool softeners, increased fiber, increased fluid
in a urinalysis, what 2 substances are focused on in a pregnancy woman
glucose, protein
how would you determine EDC using the Naegele rule
add 7 days, subtract 3 months
where should the fundus be at 16 weeks gestation
1/2 way to belly button
where should fundus be at 20 weeks
at belly button
where should the fundus be after 20 weeks
between belly button & xiphoid process
what are the symptoms of true labor vs false labor
true - water broke, dilating, regular contractions
what are characteristics of stages of labor
latent - dilated 4 cm - contractions 5-1- min(mild)
active - dilated 4-8 cm - contractions 3-5 min(moderate)
transition - dilated 8-10 cm contractions 2-3 min(strong) - nausea/vomiting
second stage
complete cervical dilation (10 cm) through birth
third stage
from birth through delivery of placenta
fourth stage
delivery of placenta through 2-4 hours post delivery
what is the duration, intensity and frequency of contractions
how long, how strong, how often
what is fetal lie
position of baby before birth(longitudinal, transverse, oblique)
what is presentation
face, head, breech
what is stage
-4 to +4
what is attitude
flexed
what is a mian concern if an opioid is given to the mother close to time of birth
respiratory depression
what is a regional block and give examples of regional block
block a group of nerves to one area of body - epidural, spinal
what is a main side effect epidural and spinal administration
maternal hypo tension
what is done prior to starting an epidural to avoid this
fluid bolus of lactated Ringers
what is genreal anesthesia used in obstetrics
emergency C-section
what is a dangerous complication with an epidural or spinal anesthesia
maternal hypo tension
what is normal fetal heart rate
110-160
what is a later deceleration and what is the first treatment for this
decreased HR after contractions - put on side
internal monitoring increases the risk for
infection
how often are assessments made in the 4th stage of labor and delivery
every 15 min
what are symptoms of the placenta detaching during the 3rd stage
gush of blood, umbilical cord lengthens
what is a common complication of a newborn that was born via C section
breathing - too much fluid in lungs
what is the word for cervical readiness - how is this determined
ripe(shortened, short, dilated)
what is the name of the scoring of cervix
bishop score
what conditions have to be met prior to using vacuum suction or forceps
cervix dilated 10 cm
what is the most important determination to see if a fetus is ready to be born
L:S: 2-1 - enough surfactant
what are signs of poor maternal bonding
look away-not feeding-not naming
what are the 3 stages of lochia, what does it look like and what is the normal progression of each
rubra - red, fleshy odor(1st 3-4 days)
serosa - pink (4-10 days)
alba - white, pale yellow (after 10 days)
what does BUBBLE
breast, uterus, bladder, bowels, lochia, episiotimy
why does breast feeding cause uterine contractions
puts off more oxytocin which increases/strengthens contractions
what is treatment for a soft uterus immediately shortly after birth
fundal massage
what maternal action can result in a low weight baby
smoking
what chronic maternal condition can result in a large baby
diabetes
why is vitamin K IM injection for the NB needed
produce clotting factors(to prevent hemorrhage)
which infant body systems undergo the biggest adjustment after birth
circulatory, respiratory
what is a safety precaution to avoid mis-identification prior to leaving a baby with a mom
arm bands on mom and baby
where are IM injections given to infants
vastus lateralis
what is the best way to prevent infant heat loss
dry, swaddle, kangaroo care, hat
what type of eye ointment is commonly used immediately after birth and why
erythromycin - so they don’t get an eye infection from vagina
what type of dressing is used on a circumcision site
gauze with Vaseline
what are benefits of breastfeeding over bottle feeding
antibodies in mothers colostrum
what is the name and appearance of the first milk immediately after birth
colostrum - yellow
when does breast milk usually come in
3rd day
what is a good way to determine if the baby is getting enough breast milk
6-8 diapers /day
what are tips for proper bottle feeding
semi reclined baby - don’t prop bottle
when is an infant most likely to contract herpes from the mother
if mom has active lesions in 3rd trimester
what is the most important goal in a mom with diabetes during pregnancy
blood glucose control
what infection can be transmitted by cants
toxoplasmosis
what is a frequent complication of high glucose levels in the first trimester of pregnancy
neural tube defects - spina bifida
what is a concern regarding mothers with pre-existing heart conditions
cause CHF, death in labor
what would you as the nurse advise them to do during pregnancy
rest, left lateral sleeping, don’t push
what is the most common cause of anemia during pregnancy
iron deficiency anemia - lack of iron
what is the biggest concern with a ruptured ectopic pregnancy
could bleed out/infection, hemorrhage
what are warning signs of impending miscarriage or premature birth
cramping, spotting, frank bleeding, clots
what are symptoms of eclampsia
seizures, coma, death
what is cervical cerclage and when is ti performed
tie cervix so baby doesn’t come preterm
what are symptoms of placental abruption
sudden constant pain, dark red vaginal bleeding, rigid abdomen, fetal distress
what is preterm labor
before 38 weeks
what is considered post term
after 42 weeks
a woman is receiving Pitocin and you notice that there is little to no uterine relaxation between contractions. what should you do
stop Pitocin
what maneuver is first used with shoulder dystocia
Mc Roberts maneuver
what group of medication would be given for hypotonic uterine dysfunction
oxytoncins
name one medication from oxytocin class
Pitocin
what is the biggest risk if the usterus is atony
bleeding
what are characteristics of a normal uterus post partum
size of grapefruit, firm
what could be the problem if the uterus is positioned to one side
bladder is full
what are symptoms and treatments for mastitis
tender, heavy, warm, erythema, fever
supportive care, antibiotics
what would you teach a mom that is going home about lochia characteristics
if it skips a phase or switches from white to pink called doctor ASAP
what is a tocolytic med
magnesium sulfate
what is magnesium sulfate antidote
calcium gluconate
what do oxytocics do
increase uterine contractions(pitocin, prosteglandins)
what do tocolytics do
stop contractions
polyhydramnios
lots of amniotic fluid
macrosomia
big baby
hyperemesis gravidarum
increased vomiting
cervical insufficiency
cervix doesn’t close ( use cerclage)
hydatiform mole
teeth, hair, bone, cyst all together
spontaneous abortion
miscarriage
preeclamsia
edema, proteinuria, increased BP
eclampsia
seizure, coma, death
placenta previa
too low and covers cervix
labor dystocia
slow labor
precipitous labor
fast labor
placental abruption
placenta tears from uterus wall
amniotic fluid embolism
amniotic fluid gets in moms blood stream
shoulder dystocia
shoulder gets stuck (babies)
umbilical cord prolapse
cord comes out early
uterine atony
soft uterus (boggy)
uterine sub involution
uterus isn’t lowering as fast as it should
Oxytocics
oxytocin - pitocin ergonovine - ergotrate methylogonovine - methergine carboprost - hemabate misoprosol - cytotec mifepristone - RU486
Tocolytics
terbutaline - brethine
magnesium sulfate
nifedipine - procardia
indomethacin - indocin
