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Knowledge Exam > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Common danger signs of pregnancy

A

Bleeding/leaking fluid
Decrease in baby’s movement
Blurry/impaired vision
Dizziness, fever, pain
Unusual/severe abdomen or back

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2
Q

Induced abortion

A

Occurs after 20 weeks when dilation and evacuation can no longer be performed, initiated by medications

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3
Q

3 specific nursing responsibilities for a woman with suspected ruptured ectopic pregnancy

A

Blood typing/cross matching
IV access
Detailed informed consent

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4
Q

Recommended folic acid dose in pregnancy

A

800 mcg per day. Taken 4 weeks prior to conception until 12th week of pregnancy

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5
Q

What is the use for folic acid?

A

Helps form the neural tube, preventing neural tube defects (Spina bifida and anencephaly)

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6
Q

Pre-eclampsia

A

High blood pressure and protein in the urine during pregnancy. Occurs in 3rd trimester. Can progress to eclampsia which is life threatening (seizures & coma)

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7
Q

Gestational diabetes

A

Body can’t produce enough insulin during pregnancy and the placenta makes hormones that lead to a build up of glucose in the blood.

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8
Q

Maternal risks of gestational diabetes

A

Increase chance of miscarriage, pre-eclampsia, developing type 2 diabetes post-partum, pre term birth, c-section

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9
Q

Foetus risks of gestational diabetes

A

High birth weight, low bsl at birth, jaundice, temporary breathing problems

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10
Q

Abruptio placentae

A

Placenta separates from the uterus wall prior to delivery after 20 weeks gestation. This leads to trauma, hypertension and blood loss

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11
Q

Placenta previa

A

Cervical dilation causes the placenta and cervix to be pulled apart, causing bleeding and baby not being able to be delivered vaginally

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12
Q

DVT in pregnancy

A

When the uterus grows and puts pressure on the blood vessels restricting blood flow from legs and pelvis = slower blood flow = DVT

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13
Q

Reasons for an emergency caesarean

A

Abnormal presentation, failure to progress, fetal distress, cord prolapse, uterine rupture, placental problems, failed induction, failed instrumental delivery, twins/triplets/baby too big

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14
Q

2 main reasons for postpartum hemorrhage

A

Uterine atony (no contraction of uterus)
Not all of placenta being delivered

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15
Q

Postpartum blues onset

A

In the first days after birth for several days or weeks

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16
Q

Postpartum depression onset

A

Onset usually in 4th week postpartum

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17
Q

Low birth weight risks

A

Early growth retardation, infectious disease, developmental delay, death during infancy and childhood

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18
Q

6 week immunisations

A

Rotarix (oral)
Infanrix hexa
Synflorix

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19
Q

3 months immunisations

A

Rotarix (oral)
Infanrix hexa

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20
Q

5 months immunisations

A

Infanrix hexa
Synflorix

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21
Q

12 months immunisations

A

Priorix
Synflorix

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22
Q

15 months immunisations

A

Hiberix
Priorix
Varivax

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23
Q

4 years immunisations

A

Infanrix IPV

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24
Q

11 and 12 years immunisations

A

Boostrix
Gardasil 9 (2 doses 6 months apart)

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25
Q

2 natural methods of contraception

A

Basal body temperature
Cervical mucus charting

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26
Q

Barrier methods of contraception

A

Condoms, Diaphragm/Cap, IUD

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27
Q

Mod of action of an IUD

A

Small plastic device that is placed in the uterus to prevent fertilisation of the egg. The copper or hormone stops sperm moving through the uterus towards the egg.

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28
Q

Copper IUD

A

99 percent effective in preventing pregnancy. No hormonal side effects

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29
Q

Mirena IUD

A

99.5 percent effective in preventing pregnancy. Uses progestogen. Women will have lighter periods

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30
Q

Best time to insert an IUD

A

During or just after a menstrual period, 6 weeks after your baby is born, immediately after an abortion

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31
Q

Risks of IUD

A

1% chance of infection after first being inserted.
Small risk of damage or perforation of the womb (roughly 1 in 1000).
Rare chance of pregnancy with an IUD in place.
Ectopic pregnancy.
Copper IUD may cause more bleeding and cramping during periods. Can also cause an allergic reaction in some people.
Mirena may initially cause irregular, light bleeding for more days than usual.
Roughly 5% chance of IUD coming out itself.

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32
Q

Hormonal methods of contraception

A

Combined oral contraceptive pill
Progesterone only pill
Depo provera
ECP

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33
Q

Combined oral contraceptive pill action

A

Preventing an egg being produced (ovulation)
thickening the cervical mucus (which stops sperm getting through)
altering the lining of the uterus so that if an egg does get fertilised it is less likely to implant and grow.

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34
Q

2 types of combined oral contraceptive pill

A

Monophasic - contains equal doses of oestrogen and progestogen
Triphasic - contains differing levels of oestrogen and progestogen, which mimics a normal menstrual cycle.

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35
Q

Progesterone only pill action

A

Thickens mucus layer in cervix to stop sperm from entering uterus and fallopian tubes. Is effective 48 hours after taking. Some can also prevent ovulation.

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36
Q

Reason why women would take progesterone only pill

A

Can’t tolerate oestrogen, have a history of blood clots, suffer from migraines, other medical conditions, breastfeeding

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37
Q

Important client education if taking progesterone only pill

A

Must be taken within 3 hours instead of 12 hours (combined pill is 12)

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38
Q

ECP action

A

Delays release of an egg from your ovary until sperm are no longer active, changes the lining of your uterus so a fertilised egg cannot implant and develop.

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39
Q

Success rate of ECP

A

95% of expected pregnancies when taken within 24 hours of sex, 85% if taken within 25-48 hours
58% if taken within 49-72 hours

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40
Q

Depo provera action

A

Contains progesterone - prevents pregnancy by stopping the ovaries releasing an egg each month. There are also changes to the lining of the womb (endometrium). Administered every 12 weeks

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41
Q

Why is a folic acid pill more beneficial than gaining it from leafy greens?

A

It is more readily absorbed and used in the body (bio-available) and stable than naturally occurring food folate

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42
Q

3 positive signs of pregnancy

A

foetal heartbeat, foetal movements, visualisation via ultrasound

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43
Q

Signs and symptoms of pregnancy

A

Amenorrhea, nausea/vomiting, breast changes, fatigue, urinary frequency

44
Q

Hormone that indicates positive pregnancy test

A

HCG

45
Q

Role of Vitamin D in pregnancy

A

Reduce risk of Vitamin D deficiency in baby.

46
Q

Lack of Vitamin D in pregnancy can cause

A

Rickets and bone development issues in baby

47
Q

Role of Iodine in pregnancy

A

Helps the body grow and develop, especially the brain

48
Q

Recommended Iodine dose while pregnant

A

Take 150mcg iodine-only tablet every day while pregnant and breastfeeding

49
Q

Name 4 teratogens

A

Alcohol, Tobacco, NSAIDs, Rubella

50
Q

What is a teratogen?

A

An agent that causes an abnormality following fetal exposure during pregnancy

51
Q

Common discomforts in 1st trimester of pregnancy

A

Morning sickness, bleeding gums, urinary frequency, nasal stuffiness and epistaxis

52
Q

Common discomforts in 2nd trimester of pregnancy

A

Heartburn, constipation, haemorrhoids, faintness/dizziness

53
Q

Common discomforts in 3rd trimester of pregnancy

A

Oedema, shortness of breath, varicose veins/phlebitis, backache

54
Q

Multigravida

A

Woman who is pregnant for at least the second time

55
Q

Signs of labour

A

Contractions, tablespoon of blood or brown sticky mucus, water breaks

56
Q

First stage of labour

A

Contractions, mucus, water breaks, cervix dilates to 10cm

57
Q

Second stage of labour

A

The neck of the womb is fully open and the baby is born. Can take 1-2 hours to push out first baby

58
Q

Third stage of labour

A

More contractions as the whenua/placenta comes away from the wall of your uterus and out your vagina

59
Q

Points to consider when assisting with emergency delivery

A

APGAR score, warm baby after birth, clamp umbilical cord, check placenta has been expelled, assess for excessive bleeding and perineal tear, massage uterus if no tear visible, encourage breast feeding

60
Q

APGAR

A

Appearance, pulse, grimace, activity, respirations. Performed 1 min and 5 min after birth. Should score 10

61
Q

Newborn screening tests

A

Weight, congenital dislocation of hips, guthrie’s test (48hr), hearing test (1 month)

62
Q

Neonatal jaundice

A

Liver is not mature enough to remove bilirubin from the blood

63
Q

How is neonatal jaundice treated

A

Phototherapy

64
Q

Low birth weight groups

A

Pre-term - born before 37 weeks
Small on time - below tenth percentile for gestational age

65
Q

What is colostrum?

A

Very first milk produced by breast

66
Q

Benefits of colostrum

A

Rich in antibodies, high in protein, vitamins and minerals

67
Q

4 signs to know baby is receiving enough milk

A

Latches off alone, breast feels softer as baby empties milk, begins to gain weight after initial weight loss, wet nappies 6-8 times a day

68
Q

Complementary feeding

A

Introduction of solid foods once breast milk no longer meets sufficient nutritional value for infant

69
Q

Exclusive breastfeeding

A

Usually up to 6 months, only received breast milk and prescribed medication

70
Q

Does breastfeeding count as contraception?

A

No. However, it does delay return of period

71
Q

6 educational factors for mothers using formula

A

Instructions for amount, sterilise equipment, warm formula by placing in bowl of warm water, check ingredients, check seal is not broken, don’t take anywhere that bacteria may grow

72
Q

Positives of breastfeeing

A

Maternal immunity, bonding, easily digestible for baby, assists mothers body to return to normal, convenient, safe, may lower risk of SIDS

73
Q

SIDS

A

Sudden Infant Death Syndrome

74
Q

Risks associated with incomplete abortion

A

Anaemia, septicaemia, increased risk of infection, excessive PV loss

75
Q

When does rupture of an ectopic pregnancy usually occur?

A

5-8 weeks

76
Q

Why is ectopic pregnancy potentially life threatening?

A

Can cause internal bleeding if ruptures

77
Q

Eclampsia

A

Progression of pre-eclampsia, seizures and coma potentially occur

78
Q

Hypertension in pregnancy

A

SBP 140, rise of 30 or more from baseline. DBP greater or equal to 90, rise of 15

79
Q

Signs and symptoms of pre-eclampsia

A

Proteinuria greater than or equal to 3g/L in 24hr urine collection, 1kg oedema, headache, visual disturbances, oliguria, convulsions, RUQ pain

80
Q

RUQ

A

Right upper quadrant

81
Q

At risk groups for developing gestational diabetes

A

Overweight prior to pregnancy, normally high blood sugar, maternal age over 25-30, family history, previous history

82
Q

Life-threatening child birth emergencies

A

Breach presentation, cord presentation and prolapse, eclampsia, trauma, rupture of uterus

83
Q

What is lochia?

A

Vaginal discharge during post-partum period

84
Q

What does lochia look like?

A

Bright red and blood in first few days, will become like discharge after 2-4 days, small amount of white or yellow after 10 days

85
Q

How long does lochia last?

A

Usually 4-6 weeks

86
Q

Braxton-hicks contractions

A

Intermittent, weak contractions of the uterus occurring during pregnancy

87
Q

How early can Braxton-hicks occur?

A

Second trimester

88
Q

What is mastitis?

A

Inflammation of the breast that may or may not be infective

89
Q

What causes mastitis?

A

A blocked milk duct or bacteria entering the breast via cracked nipple

90
Q

Advice points for mastitis

A

Continue to breastfeed, wash hands pre and post, position infant correctly, change nipple pads when wet, feed from tender breast

91
Q

Why is it important to feed from tender breast?

A

To encourage movement of milk

92
Q

Breastfeeding premature baby

A

Baby cannot suck on nipple, must express milk via NG tube

93
Q

Why can’t a premature baby suck nipple?

A

Babies do not have co-ordinated sucking reflex until 34 weeks

94
Q

Full term neonates blood volume

A

85 mL/kg

95
Q

Premature neonates blood volume

A

95 mL/kg

96
Q

Hyperemesis gravidarum

A

Excessive vomiting during pregnancy

97
Q

What percentage of pregnant women does hyperemesis gravidarum occur in?

A

0.3% to 2%

98
Q

What are the risks of hyperemesis gravidarum?

A

Dehydration, electrolyte imbalance

99
Q

Nursing management of hyperemsis gravidarum in outpatient setting

A

Antiemetics, IV therapy, hospitalisation if not resolving

100
Q

Nursing considerations of hyperemsis gravidarum in hospital setting

A

Relaxed, quiet environment away from food odours and strong smells, encourage oral hygiene, monitor weight, emotional support

101
Q

Bleeding in pregnancy

A

Approx 1/4 pregnancies have some bleeding in first trimester

102
Q

Non-emergent bleeding during pregnancy

A

Sex, implantation bleeding, infection, hormones

103
Q

More serious bleeding during pregnancy

A

Ectopic pregnancy, miscarriage, anembryonic gestation, molar pregnancy

104
Q

Diagnostic testing for pregnancy

A

Urine pregnancy test, transvaginal ultrasound, blood type with Rh factor, haemoglobin, blood B-hCG levels

105
Q
A

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