OB Test 1 Flashcards
discuss common techniques used to assess fetal well-being
- Ultrasound
- Biophysical profile
- Nonstress Test
- Contraction Stress Test
- Aminocentesis
list and explain one noninvasive way to assess fatal well-being
external abdominal ultrasound: safe, noninvasive, painless procedure whereby an ultrasound transducer is moved over a client’s abdomen to obtain an image. More useful after the 1st trimester when the gravid uterus is larger.
discuss what to teach the pregnant client with heartburn; hemorrhoids; constipation
- Heartburn: Client should eat small frequent meals, not allow the stomach to get to empty or too full, sit up for 30 min after meals and check with provider prior to using OTC antacids
- Constipation: Encourage fluids, eat a diet high in fiber and exercise regularly
- Hemorrhoids: Warm sitz bath, witch hazel pads and application of topical ointments
how is the sex/gender of the baby determined
- DNA determines baby’s gender.
- XX- female
- XY- male
- Father determines baby’s gender.
discuss common maternal discomforts during pregnancy and their treatment
- nausea/vomiting: should eat crackers (dry food) 30min to 1 hour prior to getting up in the morning to prevent feelings.
- breast tenderness: client should wear a comfortable bra with room to breath.
- urinary frequency: client should void full and often. don’t drink right before bed. practice kegal exercises. wear pads.
- UTI: avoid bubble baths, wipe front to back, cotton panties, loose underwear/pants
- fatigue: simple solution –> rest often!
- constipation: eat fiber. drink plenty of fluids. exercise 30 minutes 3x/week.
discuss the signs and symptoms of hyperemesis gravidarum
- excessive vomiting/diarrhea
- dehydration
- weight loss
- increased pulse
- decreased BP
- poor skin turgor and dry mucous membranes
discuss the client teaching following a vasectomy
following the procedure:
- scrotal support and moderate activity for a couple of days to reduce discomfort
- sterility is delayed until the proximal portion of vas deferent is clears of all remaining sperm (approx. 20 ejaculations)
- follow up for a sperm count
- no lifting heavy objects
identify vital signs in the pregnant client that should be reported to the charge nurse or provider
dizziness, lightheadedness, and cool/clammy skin should be reported
discuss the use of basal body temperature method of birth control
temperature can drop slightly at the time of ovulation. this can be used to facilitate conception, or be used as a natural contraceptive.
woman is instructed to measure oral temperature before getting out of bed in the morning.
advantage: inexpensive, convenient, no s/e
disadvantages: BBT is influenced by many factors
risk: pregnancy
list the hormone(s) measured by a pregnancy test
hCG
list expected symptoms in the early weeks of pregnancy
- Breast tenderness
- Missed period
- Nausea/vomiting
- Feeling of bloating
- Dizziness
what causes the sensation of quickening
fetal movement
discuss the care of the pregnant client in third trimester who is having vaginal bleeding
Placenta Previa:
- Monitor for bleeding, leakage or contractions
- Monitor fundal height
- Perform Leopold maneuvers (fetal position and presentation)
- Refrain from performing vaginal exams (can exacerbate bleeding)
- Assist with administration of IV fluids, blood products and medications
- Have O2 equipment available in case of fetal distress
Abruptio Placenta:
- Palpate the uterus for tenderness and tone
- Monitor FHR pattern
- Assist with the administration of IV fluids, blood products and meds as prescribed
- Adminiset O2 8-10 L via face mask
- Monitor urinary output and monitor fluid balance
list the best places to detect fetal heart tones in the first trimester, second and third trimesters
- 1st trimester: just above the pubis at the midline
- 2nd and 3rd: upper right of left quadrant
list the client instructions for taking oral contraceptives
requires a prescription and follow-up appt.
medication must be used consistently
if one dose is missed, take one pill immediately when remembered, then take next dose at scheduled time. If missing 2+ doses, see manufacturer’s instructions and use alternative form of contraceptive to prevent pregnancy.
what would the nurse expect to assess in the client who is 8 weeks? 12 weeks? 20 weeks?
8 weeks:
- At 5 weeks the embryo is ¼ inch long
- All major organ systems develop
- The placenta and umbilical cord develop
- Amniotic fluid surrounds the baby
- Face and limbs take shape
12 weeks:
- Fetus is about 1 inch long
- Nostrils, mouth, lips, teeth buds and eyelids form
- Fingers and toes are almost complete
- Eyelids are fused shut
- Arms, legs, fingers and toes have developed
- All internal organs are present- but aren’t ready to function
- The genital organs can be recognized as male of female
20 weeks:
- The fetus is about 6 inches long and weights 4-5 oz
- A protective coating called vernix begins to form on baby’s skin
- Hair eyelashes and eyebrows appear
- Organs keep maturing
- Fetus is very active
- The eyes can open and blink
explain the difference between complete, incomplete, and threatened abortion
- Complete- Mild cramps; minimal bleeding; complete expulsion of uterine contents; cervical opening is closed with no tissue in cervical canal
- Incomplete- Severe cramps; continuous and severe bleeding; partial fetal tissue or placenta; cervical opening is dilated with tissue in cervical canal or passage of tissue
- Threatened- With or without mild cramps; slight to spotted bleeding; no tissue passed; cervical opening is closed
list the risk factors for developing abrupt placenta
- maternal HTN
- blunt external trauma
- cocaine use resulting in vasoconstriction
- previous incidents of abruptio placenta
- premature rupture of membranes
- multifetal pregnancy
when should the provider be able to hear fatal heart tones using a doppler
by the 10th week
list 4 presumptive, 4 probable, and 4 positive signs of pregnancy
Presumptive:
- Amenorrhea
- Fatigue
- Nausea and vomiting
- Urinary frequency
- Breast changes- darkened areolae, enlarged Montgomery’s glands
- Quickening- slight fluttering movements of the fetus felt by a woman, usually between 16-20 weeks of gestation
Probable:
- Abd enlargement related to changes in uterine size, shape and position
- Hegar’s sign- softening and compressibility of lower uterus
- Chadwick’s sign- deepened violet- bluish color of cervix and vaginal mucosa
- Goodell’s sign- softening of cervical tip
- Ballottement- rebound of unengaged fetus
- Braxton Hick’s contractions- false contractions; painless, irregular and usually relieved by walking
- Positive pregnancy test
- Fetal outline felt by examiner
Positive:
- Fetal heart sounds
- Visualization of fetus by ultrasound
- Fetal movement palpated by an experienced examiner
discuss how to prepare a client for a pelvic exam
- empty bladder before exam
- no sex a few days before
- lithotomy position
- provide pads if bleeding
- don’t schedule on menses