OB prep work study guide quiz Flashcards
Magnesium Sulfate
Careful monitoring for s/s of magnesium toxicity:
- Decreased or absent reflexes
- Decreased respiratory rate
- Change in LOC
uterus infection from prolonged PRM s/s:
maternal fever
maternal and fetal tachycardia
uterine tenderness
purulent amniotic fluid
s/s of pre-eclampsia
- Elevated BP
- Epigastric pain
- CNS changes
- Bleeding
- n/v
- low platelets
- DIC
- Renal failure
- HELLP
- Proteinuria
- Facial edema
- Ascites
- Pleural effusions
What is the antidote for Magnesium Toxicity?
The reversal agent is IV calcium gluconate
how is GBS transmitted from mom to baby
Transmission of GBS to the neonate from mothers who are colonized usually occurs:
- just before birth – PROM
- during birth – vertical transmission from the birth canal.
- When should GBS prophylaxis be administered?
When GBS positive women are in labor
placental abruption vs placenta previa
Premature separation of the placenta; the detachment of part or all of a normally implanted placenta from the uterus before the birth of the infant.
placental abruption = placenta detachment
placental abruption vs placenta previa
Placenta is implanted in the lower uterine segment such that it completely or partially covers the cervix or is close enough to the cervix to cause bleeding when the cervix dilates or the lower uterine segment effaces.
placenta previa = placenta over cervix
Cervix can’t stay closed during pregnancy is called ?
cervical insufficiency
? is the use of nonabsorbable suture to constrict the internal os of a cervix that is dilating prematurely. The suture can be placed vaginally or abdominally. can be placed either prophylactically or as a rescue procedure.
Sutures are removed later in pregnancy when the woman is ready to deliver
cerclage
(the time from the beginning of one contraction to the beginning of the next)
frequency
(length of contraction)
duration
strength of contraction at its peak).
intensity
latent vs active phase
_______ phase extends from the onset of labor, characterized by regular uterine contractions that cause cervical change, to when cervical dilation occurs more rapidly
phase 1a latent
latent vs active phase
_____ phase has more rapid dilation of the cervix and increased rate of descent of the presenting part. the period during which the greatest rate of cervical dilation occurs, which begins at 6 cm and ends with complete cervical dilation at 10 cm
phase 1b active
what phase is the birth of the baby until the placenta is expelled
third phase
pushing phase
second phase
when the cervix begins to open during labor.
Dilation
The shortening and thinning of the cervix during the first stage of labor.
effacement
potential hazards when a patient pushes at 9 cm or less.
cervical injury
uterine rupture
fetal distress
prolonged labor
________ is
Term used to indicate that the largest transverse diameter of the presenting part (usually the biparietal diameter) has passed through the maternal pelvic brim or inlet into the true pelvis and corresponds to station 0.
engagement
__________ is
Relationship of the presenting fetal part to an imaginary line drawn between the ischial spines of the pelvis. It is a measure of the degree of descent of the presenting part of the fetus through the birth canal.
station
Normal baseline range of FHR
110 to 160 beats/min
irregular waves or fluctuations in the baseline FHR of two cycles per minute or greater
Variability
which type of variability - Moderate, minimal, absent, marked
amplitude range of the FHR fluctuations that is not detectable to the unaided eye.
an amplitude range that is detectable to the unaided eye but is 5 beats/min or less
is considered normal, amplitude range 6 - 25 beats/min
amplitude range 25 or more beats/min
Absent variability -
Minimal variability -
Moderate variability -
Marked amplitude -
Fetal tachycardia
baseline FHR greater than ___ beats/min for __ minutes or longer
Fetal tachycardia
baseline FHR greater than 160 beats/min for 10 minutes or longer
Fetal bradycardia
baseline FHR less than ___ beats/min for __ minutes or longer
FHR <110 beats/min lasting >10 min
nursing care for ______________:
- Discontinue oxytocin if infusing.
- Assist woman to lateral (side-lying) position.
- Correct maternal hypotension by elevating legs.
- Increase rate of maintenance IV solution.
- Palpate uterus to assess for tachysystole.
- Notify obstetric health care provider
- Consider internal monitoring for more accurate fetal and uterine assessment.
- Assist with birth (vaginal-assisted or cesarean) if pattern cannot be corrected.
bradycardia
visually apparent, abrupt (onset to peak <30 seconds) increase in FHR above the baseline rate
After 32 weeks, The peak is at least 15 beats/min above the baseline, and the acceleration lasts 15 seconds or more, with the return to baseline less than 2 minutes from the beginning of the acceleration.
Before 32 weeks of gestation, the definition of acceleration is a peak of 10 beats/min or more above the baseline and a duration of at least 10 seconds.
accelerations
visually apparent, gradual (onset to lowest point ≥30 seconds) decrease in and return to baseline FHR associated with UCs.
Early decelerations
visually abrupt (onset to lowest point <30 seconds) decrease in FHR below the baseline.
The decrease is at least 15 beats/min or more below the baseline, lasts at least 15 seconds, and returns to baseline in less than 2 minutes from the time of onset
variable decelerations
visually apparent, gradual (onset to lowest point >30 seconds) decrease in and return to baseline FHR associated with UCs. The deceleration begins after the contraction has started, and the lowest point of the deceleration occurs after the peak of the contraction.
Late decelerations
categories of FHR tracings
FHR tracings are normal and strongly predictive of normal fetal acid-base status at the time of observation. These tracings may be followed routinely and do not require any specific action.
FHR tracings are indeterminate.
FHR tracings are abnormal. Immediate evaluation and prompt intervention are required when these patterns are identified
Category I
Category II
Category III
The return of the uterus to a nonpregnant state after birth is called
This process begins immediately after expulsion of the placenta with contraction of the uterine smooth muscle.
involution.
? is the failure of the uterus to return to a nonpregnant state as a result of ineffective uterine contractions.
The most common causes
Subinvolution
retained placental fragments and infection
A major intervention to alleviate uterine atony (boggy uterus) and restore uterine muscle tone is stimulation by
gently massaging the fundus until firm
intravenous fluids and oxytocic medications (drugs that stimulate contraction of the uterine smooth muscle)
How does a distended bladder increase vaginal bleeding after delivery?
A full bladder causes the uterus to be displaced above the umbilicus and well to one side of midline in the abdomen. It also prevents the uterus from contracting normally.
Cord clamp in place for ________ hours
24–48
hypothermia creates a vicious cycle in a newborn. As the baby gets colder, they need more _____, but their body struggles to take __________, leading to ____________
hypothermia creates a vicious cycle in a newborn. As the baby gets colder, they need more oxygen, but their body struggles to take in and utilize oxygen effectively, leading to respiratory distress.
Should a baby that does not receive Vitamin K have a circumcision in the first few days of life? Why or why not?
Male infants who do not receive the vitamin K injection are significantly more likely to bleed after circumcision
