OB test 13

Question 1

Hypertonic uterine dysfunction

Answer 1

contractions Q 1-1/2 minutes, duration 90 sec, baseline 10mmhg.
Dilation and effacement does not progress.

Question 2

Hypotonic uterine dysfunction

Answer 2

contractions Q 7 minutes, 50 sec duration, intensity increases 25mmhg.
Initially good labor, uterus tires at 4 cm dilation.

Question 3

Precipitous labor

Answer 3

rapid, less than 3 hours.

Problem- trauma to mom or baby.

Question 4

prolonged labor

Answer 4

exceeds normal time >20 hrs.

Question 5

Arrested labor

Answer 5

progress stops, fetal descent stops.

Cause- CPD, fetal malproportion

Question 6

CPD

Answer 6

cepelopelvic disportion- baby head cannot fit

Question 7

Shoulder dystocia

Answer 7

baby descends and should gets stuck behind symphysis pubis.

Tx- suprapubic pressure, mcroberts manuter (keens to chest), woodys screw manuver- turn baby.

Question 8

Velamentous intersion

Answer 8

cord divides before connecting to the placenta.

Risk- hemorrhage, increase risk compression.

Question 9

Abnormal cord length

Answer 9

long- inc nuchal cord/knots

short- conpression, abrupt placenta

Question 10

Prolapsed cord

Answer 10

ROM before presenting part is snug in pelvis.
Risk- cord rushes out with water
tx- get presenting part off cord, rish C/S

Question 11

Succenturiate placenta

Answer 11

accessory lobe. Continues to bleed after delivered placenta (fundus will be firm)
Risk- can detach=hemorrhage

Question 12

Circumvallate placenta

Answer 12

double fold of anmion and chorion. Sec surface are for blood vessels to perfuse.
risk fetal dealth, SGA, premature

Question 13

Battledorf placenta

Answer 13

cord insterts at margin= poor circulation

Question 14

Placental infarcts/calcification

Answer 14

Ca deposits= old placenta

Question 15

Placenta previa

Answer 15

implants lower uterine segment. WILL LEAK BLOOD.
Mom anemic, hemorrage during preg.
DR MUST CHECK, not a RN

Question 16

Abruptio placenta

Answer 16

premature separation of normally implanted placenta after 20 wks
S&S- pain btw contraction, late decals.

Question 17

Amniotic fluid embolism

Answer 17

amniotic fluid enter materal blood. S&S- resp distress, brain, dyspnea, hypotension

Question 18

Sedative (ambien, phenergan, benadryl)

Answer 18

used during false/early labor. FETUS greatly effected.

Admin at peak of contraction- fetus will be less effected

Question 19

Pudendal- regional anesthesia

Answer 19

nerve, either side of perineum. relief perineal stretching. No used often.

Question 20

General anasthesia

Answer 20

Emergeny C/S, crosses placenta. prepare for fetal resussitation.

Question 21

Spinal anasthesia

Answer 21

subarachnoid space, mom can’t move legs.

SE- spinal HA

Question 22

Epidural anastheais

Answer 22

block motor and sensory perception. Can limit ability to push and need to void.

Question 23

Bishop score

Answer 23

predict inducibility- higher= better

Question 24

Amniotomy

Answer 24

prostaglandins release when ROM occurs

Risk- prolapse cord, infection

Question 25

Membrane stripping

Answer 25

digitally frees membranes of amnoitic sac from lower segment of uterus around cervical os. Prostaglandin release, labor in 48 hrs.

Question 26

Cervidil

Answer 26

prostaflandin prep in vag insert. slow rate

Question 27

Prepidil

Answer 27

intracervical gel, release prostaglandin faster. increase vag delivery in 24 hrs.

Question 28

Misoprostol

Answer 28

synthetic prostaglandin. intervaginal tab

Question 29

Oxytocin

Answer 29

IV, stim contraction that produce cervical changes and fetal descent.

Question 30

Version

Answer 30

turn fetus in uterus from undesirable to desirable prosition.

Question 31

External cephalic version

Answer 31

moves baby by palpating on abdomen external abdomen (no past c/s, placenta previa)

Question 32

Internal/podalic version

Answer 32

used with multiple gestation to deliver second twin. | Med to relax uterus, ob grabs feet and pulls to feet presentation

Question 33

Episiotomy

Answer 33

surgical incision of the perineum. midline- downwarn towards sphincter mediolateral-45 degree angle on left or right

Question 34

Forceps

Answer 34

used for any conditiont hat threatens mom or fetus that can be relieved by birth OR shorten 2nd stage

Question 35

Criteria for forceps

Answer 35

``` fully dilated head engaged mom bladder empty adequate anathema ROM continuous external fetal monitoring ```

Question 36

Vaccume assisted birth

Answer 36

criteria- ROM, head fits, lithotomy position. | NO if- face presentation, CPD, premature, scalp blood samping, small fetus

Question 37

VBAC

Answer 37

vaginal birth after cesarean. | NPO, anasthesiologist and OR dr avalible, NO classical incision.

Question 38

Caput Succedaneum

Answer 38

Localized swelling of scalp.

Question 39

Cephalhematoma

Answer 39

subperiosteal hemorrhage. Bleeding

Question 40

Diffuse scalp hemorrhage

Answer 40

bleeding into scalp. Severe swelling. | Transfusion PRN, neuro assess.

Question 41

Subcutaneous fat necrosis

Answer 41

Localized lesion, inflammation of subQ tissue. Firm lesion. resolves 6-8 wks

Question 42

Abrasions/lacerations

Answer 42

forceps, C/S accidental cut, fetal scalp monitor. | tx- clean, abx, watch S&S of infection.

Question 43

Petechaie/ecchymosis

Answer 43

nuchal/mechanical device. | Observe hyperbilirubinemia

Question 44

Subconjunctival hemorrhage

Answer 44

Presure during delivery. Resolves 1-2 wks

Question 45

Retinal hemorrhage

Answer 45

Head compression. | 1-5 days

Question 46

Brachial plexus

Answer 46

lateral traction on neck . C5-T1 innerate arm- stretched INC risk with asphyciated baby (dec tone)

Question 47

Erbs palsy

Answer 47

C5&C6 arm limp at side, internal oration, arm extended, finger and arm flexed. (Waiter exspecting money form) Moro- fingers move, arm does not

Question 48

Klumpke

Answer 48

``` C8-T1 Weakness wrist and fingers hand paralyzed Moro- shoulder moves, hand does not. SPLINT TO PREVENT CLAW DEFORMITY ```

Question 49

Phernic nerve paralysis

Answer 49

C4-C5 Dec breath sounds on affected size, labored reap. Better in 6 weeks. PRN support (O2, vent)

Question 50

Facial nerve injuries

Answer 50

Pressure from position or delivery | 2wk-2mth recovery

Question 51

Fractures

Answer 51

Dec movement, tender, palpable, deformity, normal moro | Tx- pain management, careful handling

Question 52

Torticollis-sternocleidomastoid muscle injury

Answer 52

hyper extension during delivery. hematoma formation=shortens muscle tx- passive stretching 6 m, then surgery.

Question 53

Spinal cord injury

Answer 53

Rare, breech