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Module 6 > OB Test 4 > Flashcards

OB Test 4 Flashcards

1
Q

onset of labor before 37 weeks (uterine contractions and cervical changes that occur between 20 and 37 weeks

A

preterm labor

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2
Q

gestational age at birth <37 weeks

A

preterm birth

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3
Q

born after 20wks: before 37 wks

A

preterm/preterm infant

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4
Q

diagnosing preterm labor

A

gestational age >20 wks and <37 weeks
documented regular uterine contractions of >6/hr and at least one of the following:
rupture of membranes
cervical change (cervix > 1 cm dilated or 80% effaced

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5
Q

management of ______ labor is focused on _______ uterine contractions

A

preterm; stopping

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6
Q

medications used to suppress uterine contractions in preterm labor

A

tocolytic drugs

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7
Q

what are the 4 tocolytic drugs

A

magnesium sulfate
prostaglandin synthesis inhibitors
calcium channel blockers
beta adrenergic agonists

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8
Q

what is the antidote for magnesium sulfate toxicity

A

calcium gluconate

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9
Q

what are S/S or magnesium sulfate toxicity

A 
absent DTRs
resp <12
severe hypotension
decreased LOC
pulmonary edema
chest pain
urine output <30ml/hr
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10
Q

when should you not give prostaglandin synthesis *indomethacin

A

don’t give after 32 wks of pregnancy because it closes the PDA and we don’t want this done in utero
also DO NOT use longer than 48 hours

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11
Q

when should calcium channel blockers (Nifedapine, Nicardipine) NOT be used

A

should not be admin with magnesium sulfate or terbutaline

*hold dose for BP <90/50 or HR >120

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12
Q

what is given to stop contractions if baby is not looking good on the fetal monitor

A

beta adrenergic agonistist (terbutaline)

*monitor maternal HR and hold for HR >120

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13
Q

mechanical defect in cervix; results in painless cervical dilation in second trimester; can progress to bulging of membranes into vagina and premature delivery

A

incompetent cervix

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14
Q

for pets who have incompetent cervix what can be done

A

cerclage= purse string suture placed submucosally around the cervix to reinforce, strengthen and prevent cervical dilation

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15
Q

one chorion (one placenta)

A

monochorionic

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16
Q

two chorions (two placenta)

A

dichorionic

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17
Q

share same amniotic sac

A

monoamniotic

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18
Q

what is the problem with twins have monochorionic with 2 cords coming out (one placenta)

A

donor twin becomes anemic and small, recipient twin becomes bigger and may have cardiac problems because getting too much fluid

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19
Q

when babies are monochorionic and mono amniotic the cords can get

A

tangled and have a mortality rate that is high from twin to twin transfusion and tangling of cords

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20
Q

vomiting during pregnancy so severe it leads to dehydration, electrolyte and acid base imbalance, starvation ketosis, and weight loss; prolonged past 12 weeks gestation

A

hyperemesis gravidarum

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21
Q

abstaining form sexual intercourse

A

natural family planning abstinence

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22
Q

withdrawal of penis prior to ejaculation

A

coitus interruptus- withdrawal

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23
Q

what is important to teach pt about withdrawal method

A

be aware of fluid leaking form penis

*good choice for MONOGAMOUS couple with religious conviction

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24
Q

method that requires exclusive breastfeeding

A

lactational amenorrhea

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25
what is important to teach pt about lactational amenorrhea
effectiveness is enhanced by frequent feedings or use of barrier method disruption of breastfeeding or supplementation increases risk of pregnancy need an alternate method if stopped breastfeeding, supplementing, menses returns, or if infant is 6 months
26
what is the disadvantage of lactational amenorrhea
the 1st ovulation is unpredictable
27
requires awareness of menstrual cycle
fertility awareness- based methods
28
what are the disadvantages of fertility awareness- based methods
not ideal for irregular periods, breastfeeding, and perimenopause
29
what are the fertility awareness methods
calendar method basal body temp cervical mucus lactational amenorrhea
30
record cycles, calculate ovulation 14 days prior to cycle, avoid intercourse during fertile time
calendar method
31
what is important to teach pt about the calendar method
record number of day for each menstrual cycle starting on 1st day for 6 cycles fertile period= subtract 18 from shortest and 11 from longest cycle *avoid intercourse during this time
32
measure oral temp daily, to identify a slight temp DROP which occurs at ovulation
basal body temp
33
what is important to teach pt about basal body temp
measure oral temp each morning prior to getting out of bed
34
what are the disadvantages of basal body temp
reliability is affected by stress, fatigue, illness, environmental temperature
35
spinnbarkeit sigh- cervical mucus becomes thin, flexible and stretch between fingers at ovulation
cervical mucus
36
what is important to teach pt about cervical mucus contraception
hand hygiene | obtain and examine mucus for thinning characteristics from vaginal introitus
37
what are complications of cervical mucus examination
inaccurate intercourse when mucus is mixed with blood, semen, contraceptive foam, and discharge *avoid intercourse when mucus is scratchy and egg white consistency
38
sheet covering worn over penis during intercourse, prevents sperms form entering uterus
male condom
39
what is important pt teaching about the male condom
place condom on erect penis, leaving empty space at tip for semen after ejaculation, rim of condom is held to prevent spillage heat accelerates deterioration, breaks
40
sheet inserted into the vagina prior to intercourse, prevents sperm from entering uterus
female condom
41
what is important pt teaching for female condom
insert condom gently pushing toward the back of vagina, making sure the inner ring fits over cervix and outer ring rest over vaginal opening
42
chemical gel, foam, cream or suppository inserted vaginally prior to intercourse to destroy sperm
spermicidal agents
43
what is important pt teaching of spermicidal agents
must be reapplied for multiple acts | inserted prior to intercourse
44
latex/silicone dome fitting over the cervix
diaphragm
45
what is important pt teaching about the diaphragm
refitting every 2 years, after childbirth, or 20% gain or loss of weight insert with spermicide cream applied to rim and cervical side must remain in place for 6 hours before removal can remain in place for 24hrs for multiple acts *reapply spermicide and wash with soap and water after use
46
soft, thimble shaped silicone or latex cup which fits snugly over the cervix
cervical cap
47
what is important pt teaching of cervical cap
coat inside of cap with spermicide can keep in for 24hours requires a prescription refit every 2 years, after childbirth, weight gain or loss must be left in for 6 hours after intercourse clean with soap and water after each use
48
pillow shaped, soft, absorbent cup shaped sponge which fits over the cervix containing spermicide
vaginal sponge
49
what is important pt teaching about vaginal sponge
moistened with water and inserted vaginally must remain in place for 6 hours after intercourse and can stay in up to 24 hours *only good for one time use but can be used for multiple acts in 24hours
50
what is one of the complications of the vaginal sponge
absorbs vaginal secretions leading to vaginal dryness
51
estrogen and progestin- suppresses ovulation, thicken cervical mucus, alters uterine lining to prevent implantation
combined oral contraceptives
52
what are side effects of oral contraceptives
nausea, headache, spotting, weight gain, breast tenderness
53
who should avoid combined oral contraceptives
pt with history of blood clot, stroke, heart disease and cancer
54
progestin ONLY- suppresses ovulaiton, thickens cervical mucus, alters uterine lining to prevent implantation
minipill
55
what is important pt teaching about the minipill
one pill same time daily | missed dose requires alternate type of birth control
56
which oral contraceptive will docs prescribe to breastfeeding moms
minipill
57
subcutaneous continuous delivery of progesterone and ethinyl estradiol
transdermal contraceptive patch
58
what is important pt teaching of transdermal contraceptive patch
prescription apply patch for 3 wks to buttock, abd, upper arm or torso and remove on the 4th wk * less effective on larger women * avoids liver metabolism and not absorbed in GI tract
59
intramuscular injection of progestin given every 11-13wks. LONG term birth control >2years
depo-provera
60
what is important pt teaching of depo-provera
1st dose given during first 5 days of menstrual cycle if postpartum, bottle feeding first 5 days/breastfeeding 6th week *keep follow up appointments *maintain adequate calcium and vit D for bone health
61
what is the disadvantage of the depo- provera injection
decreased bone density | *once the injections are stopped, bone density returns to normal
62
flexible soft vaginal ring filled with a low dose of combined hormones which are released continuously
nuvaring
63
what is important pt teaching of the nuvaring
requires a prescription keep in refrigerator until use -insert for 3 wks then remove for one week if ring falls out must use alternate protection for one week *ring does not need to be fitted
64
morning after pill high dose of estrogen and progestin that prevents fertilization
emergency oral contraceptive
65
what is important teaching of Plan B
take within 72 hrs of unprotected sex not used regularly for birth control older than 17 can purchase over the counter *does not terminate an already established pregnancy
66
minor surgical implantation of a single hormone filled rod to the upper arm
implanon
67
what are the advantages of the implanon
continuous long acting contraception for 3 years it is reversible can be used if lactating once breastfeeding established for 4 wks
68
what is the disadvantage of implanon
removal required
69
chemical or hormone active device which is inserted into uterus, damages sperm, and prevents fertilixation
intrauterine device
70
what is important pt teaching of intrauterine device
inserted by provider in office check device presence monthly after each menstrual cycle safe for breastfeeding mothers *COPPER IUD- emergency contraceptive if placed within 5 days of intercourse
71
metallic implant placed in fallopian tubes resulting in scar tissue, blocking the tunes to prevent conception
transcervical implant essure
72
what is important pt teaching of essure
office procedure wit quick return to normal activities exam in 3 most following to ensure fallopian tubes are blocked (use protection until confirmed) *not reversible
73
fallopian tubes are surgically cut, tied, burned and blocked to prevent conception
bil tubal ligation salpingectomy
74
what is important pt teaching about tubal ligation
surgical procedure with anesthesia *permanent sterilization sexual function is unaffected
75
vas deferens is surgically severed and ligated under local anesthesia
vasectomy (male sterilization)
76
what is important teaching of a vasectomy
surgical office procedure alternate birth control until confirmed with 2 negative sperm counts considered irreversible *sexual function not impaired

Module 6 (11 decks)

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