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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
Q

what is important to teach pt about lactational amenorrhea

A

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

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26
Q

what is the disadvantage of lactational amenorrhea

A

the 1st ovulation is unpredictable

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27
Q

requires awareness of menstrual cycle

A

fertility awareness- based methods

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28
Q

what are the disadvantages of fertility awareness- based methods

A

not ideal for irregular periods, breastfeeding, and perimenopause

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29
Q

what are the fertility awareness methods

A

calendar method
basal body temp
cervical mucus
lactational amenorrhea

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30
Q

record cycles, calculate ovulation 14 days prior to cycle, avoid intercourse during fertile time

A

calendar method

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31
Q

what is important to teach pt about the calendar method

A

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
Q

measure oral temp daily, to identify a slight temp DROP which occurs at ovulation

A

basal body temp

33
Q

what is important to teach pt about basal body temp

A

measure oral temp each morning prior to getting out of bed

34
Q

what are the disadvantages of basal body temp

A

reliability is affected by stress, fatigue, illness, environmental temperature

35
Q

spinnbarkeit sigh- cervical mucus becomes thin, flexible and stretch between fingers at ovulation

A

cervical mucus

36
Q

what is important to teach pt about cervical mucus contraception

A

hand hygiene

obtain and examine mucus for thinning characteristics from vaginal introitus

37
Q

what are complications of cervical mucus examination

A

inaccurate intercourse when mucus is mixed with blood, semen, contraceptive foam, and discharge
*avoid intercourse when mucus is scratchy and egg white consistency

38
Q

sheet covering worn over penis during intercourse, prevents sperms form entering uterus

A

male condom

39
Q

what is important pt teaching about the male condom

A

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
Q

sheet inserted into the vagina prior to intercourse, prevents sperm from entering uterus

A

female condom

41
Q

what is important pt teaching for female condom

A

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
Q

chemical gel, foam, cream or suppository inserted vaginally prior to intercourse to destroy sperm

A

spermicidal agents

43
Q

what is important pt teaching of spermicidal agents

A

must be reapplied for multiple acts

inserted prior to intercourse

44
Q

latex/silicone dome fitting over the cervix

A

diaphragm

45
Q

what is important pt teaching about the diaphragm

A

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
Q

soft, thimble shaped silicone or latex cup which fits snugly over the cervix

A

cervical cap

47
Q

what is important pt teaching of cervical cap

A

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
Q

pillow shaped, soft, absorbent cup shaped sponge which fits over the cervix containing spermicide

A

vaginal sponge

49
Q

what is important pt teaching about vaginal sponge

A

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
Q

what is one of the complications of the vaginal sponge

A

absorbs vaginal secretions leading to vaginal dryness

51
Q

estrogen and progestin- suppresses ovulation, thicken cervical mucus, alters uterine lining to prevent implantation

A

combined oral contraceptives

52
Q

what are side effects of oral contraceptives

A

nausea, headache, spotting, weight gain, breast tenderness

53
Q

who should avoid combined oral contraceptives

A

pt with history of blood clot, stroke, heart disease and cancer

54
Q

progestin ONLY- suppresses ovulaiton, thickens cervical mucus, alters uterine lining to prevent implantation

A

minipill

55
Q

what is important pt teaching about the minipill

A

one pill same time daily

missed dose requires alternate type of birth control

56
Q

which oral contraceptive will docs prescribe to breastfeeding moms

A

minipill

57
Q

subcutaneous continuous delivery of progesterone and ethinyl estradiol

A

transdermal contraceptive patch

58
Q

what is important pt teaching of transdermal contraceptive patch

A

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
Q

intramuscular injection of progestin given every 11-13wks. LONG term birth control >2years

A

depo-provera

60
Q

what is important pt teaching of depo-provera

A

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
Q

what is the disadvantage of the depo- provera injection

A

decreased bone density

*once the injections are stopped, bone density returns to normal

62
Q

flexible soft vaginal ring filled with a low dose of combined hormones which are released continuously

A

nuvaring

63
Q

what is important pt teaching of the nuvaring

A

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
Q

morning after pill high dose of estrogen and progestin that prevents fertilization

A

emergency oral contraceptive

65
Q

what is important teaching of Plan B

A

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
Q

minor surgical implantation of a single hormone filled rod to the upper arm

A

implanon

67
Q

what are the advantages of the implanon

A

continuous long acting contraception for 3 years
it is reversible
can be used if lactating once breastfeeding established for 4 wks

68
Q

what is the disadvantage of implanon

A

removal required

69
Q

chemical or hormone active device which is inserted into uterus, damages sperm, and prevents fertilixation

A

intrauterine device

70
Q

what is important pt teaching of intrauterine device

A

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
Q

metallic implant placed in fallopian tubes resulting in scar tissue, blocking the tunes to prevent conception

A

transcervical implant essure

72
Q

what is important pt teaching of essure

A

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
Q

fallopian tubes are surgically cut, tied, burned and blocked to prevent conception

A

bil tubal ligation salpingectomy

74
Q

what is important pt teaching about tubal ligation

A

surgical procedure with anesthesia
*permanent sterilization
sexual function is unaffected

75
Q

vas deferens is surgically severed and ligated under local anesthesia

A

vasectomy (male sterilization)

76
Q

what is important teaching of a vasectomy

A

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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