Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > Self-paced module 2 > Flashcards

Self-paced module 2 Flashcards

1
Q

When is the recommended period of abstinence PP? Why?

A

4-6 weeks is recommended (culture dependent can be 6months to a year)
Can resume intercourse at 2-4 weeks when bright red bleeding has stopped and their perineum is healed

Allow for healing
Prevent infection
Promote child spacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long does diminished libido last? What causes it?

A

Can last for up to a year

Decreased lubrication – more common if women is breastfeeding
Pain from episiotomy, laceration or c-section incision
Fatigue – rather sleep
Body self-image – women’s body changes
Feelings of constantly putting out while caring for a newborn –> emotional exhaustion so no energy left to connect with a partner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What occurs r/t the return of mensuration in the PP period?

A

Difficulty to predict return to fertility
Could be as soon as 4 weeks – year until weaning occurs
First cycle could be really heavy, and they may or may not ovulate
If they do not ovulate, then they will just have a period and then ovulate in the second cycle
If they do ovulate there is a risk of pregnancy prior to having the first period unless using contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What increased risks are unplanned pregnancies associated with?

A

Delayed initiation in prenatal care
Increased risk of PP depression
Reduced likelihood of breast feeding
Increased risk of physical violence during pregnancy
Increased risk of birth defects
Increased risk of low-birth-weight babies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are increased risks of unplanned pregnancies in teens?

A

Associated with lifetime lower educational attainment
Lower incomes
Increased risk for their own children:
1. Son: more likely to be incarcerated
2. Daughter: more likely to become teen mom themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is considered a closely spaced pregnancy? What are the risks?

A

0-18 months after birth

Early pregnancy loss
Placental abruption and previa
Anemia
Cervical incompetence
Uterine rupture
Preterm birth
Low birth weight
Pre-eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the definition of failure rate? What is it based off?

A

percentage of women experiencing an unintended pregnancy within the 1st year of use

Based on typical use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When breast feeding what kind of contraception should be avoided?

A

Avoid estrogen containing products  decreased milk supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What vaginal changes occur during breast feeding? What can be done?

A

Increase vaginal dryness d/t lower levels of estrogen during breastfeeding

Recommended to use a water-based lubricant during intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the considerations for bottle feeding r/t contraception?

A

Any method can be used

Avoid estrogen in the first 6 weeks d/t risk of DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When getting PP back on a contraceptive option what should be asked?

A

Previous history
o Was she able to use it correctly
o Any side effect experience
o Why she stopped using it
Future desire for fertility?
What method does she want?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most important thing while finding a good BC method?

A

Need to find a method that the patient is going to use tolerate best. If there is a side effect that she doesn’t like, then she will likely stop using it so you need to find a method with minimal bothersome side effects and meets needs. Also do want to use a method that is going to make normal bothersome side effects of menses worse.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When should birth control be initiated after birth?

A

Legal reasons recommend waiting 6 weeks before using method

BUT healthcare workers need to consider the patients desires and low likely she is to resume intercourse and be at risk for pregnancy without protection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is lactation amenorrhea method? Is it safe in breastfeeding? When can it be used?

A

Fertility based method and dependent on regulation of hormones

Safe in breastfeeding

Short term option only appropriate for first 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the effectiveness of LAM? What is this effectiveness dependent on? If any of these occur then?

A

Up to 98% effective with perfect use if:
* Exclusive breastfeeding (no supplemental, no solids, minimal binky use)
* Breastfeeding on demand at least every 4 hours during day and every 6 hours at night
* Menstruation has not resumed
* Baby is UNDER 6 months

New method needs to be initiated if any of these conditions are not met

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Your patient is using the LAM for contraception and her period has come back what does this mean?

A

Once period comes back, ovulation is assumed but ovulation can occur before first period so there is still a risk of

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some things that decrease the effectiveness of LAM?

A

pumping, decreased co-sleeping, supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the failure rate for sondoms with typical use? What increases effectiveness? Decreases effectiveness?

A

Failure rate: 20% with typical use

Increased effectiveness when combined with spermicide

Less effective if left in drawer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Are condoms safe in breastfeeding?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are special considerations r/t condom use?

A

Water based lubricant strongly recommended – increased friction from condom

DO NOT use both male and female condoms at the same time – friction between the two can cause tears

Decreases risk for STIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the failure rate of diaphragm with typical use? What is necessary to be effective?

A

Failure rate: 12% with typical use

In order to be effective, the correct size is required
1. Takes at least 6 weeks for vagina to achieve the size/shape that will be her new normal
2. Needs to be sized by a healthcare professional at/after 6 weeks and for every 20 pounds of weight gain or loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Can a diaphragm be used with breast-feeding? What increases its effectiveness?

A

YES

Use with spermicide to be more effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the failure rate of a sponge? When is it not recommended? Is it safe with breastfeeding?

A

Failure rate: 25% with typical use after women have had children

NOT recommended for women who have had children d/t this

Yes safe in breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How does a sponge work to prevent pregnancy?

A

Disposable single-time use method that is placed in the vagina
Covers cervix and works by blocking sperm and releasing spermicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the types of E&P methods? What is their failure rate with typical use?

A

Pills
Ring
Patch

9% failure with typical use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Can you use combination methods while breastfeeding? What if you are not breastfeeding?

A

NO – decreased milk supply

Not recommended in the first 6 weeks d/t risk for DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the method of action for combined methods? Common side effects?

A

Prevents ovulation and blocks sperm

Breast tenderness and N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How should the combined pill be taken?

A

Active pill with E&P is taken each day for 21-24 days. Fourth week is a placebo pill where menses will occur
Many take active pill continuously for 3 months/time –> 4 menses/year
Best if take at same time each day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where should the patch be placed? How should it be worn?

A

Patch with E&P which can be worn on butt, back, belly, and arms
Need to rotate the site that is used to prevent skin irritation
New patch weekly for the first 3 weeks of cycle
Fourth week is patch free for menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How should be ring be placed? Does it need to be checked?

A

Women insert ring into vagina near cervix
Left in place for 21 days and removed for 7 days for menses
Frequently check to ensure it is still in the correct place just prior to intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the progesterone only contraception options?

A

Mini pill
Emergency contraception
Depo-provera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the effectiveness of the mini pill? What increased its effectiveness?

A

9% w/ typical use

More effective if exclusively breast feeding and in first 6 month PP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How should the mini pill be taken? When can it begin PP? What are the SE?

A

Must take at the same time each day

Begin at 2 weeks PP

SE: irregular bleeding and bleeding between periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the effectiveness of emergency contraception? What increases the effectiveness

A

95% effective but decreased to 89% if used at 72 hours
More effective if taken within 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is emergency contraception? When can it be taken? SE?

A

Pill contains a large amount of progesterone

Can be taken up to 72 hours after unprotected intercourse

SE: N/V, irregular bleeding/heavy menses, HA, abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the failure rate with depo-provera? How often is it given?

A

6% with typical use

Given every 12 weeks and can be given prior to discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the SE of depo-provera?

A

Irregular bleeding
Amenorrhea
Increased risk of depression (worse with this b/c not easily reversible - takes 3 months) – therefore hx of depression should use with caution
Delayed fertility – can take up to 18 months after last shot

38
Q

What is the effectiveness of an IDU? What increased the risk of explosion? What is the maintenance?

A

Over 99% effective with typical use

Once placed – women should check the string length after menses or periodically

Higher rate of explosion if IUD was placed immediately after birth

39
Q

What are the benefits of an IUD?

A

Effective
Easy to use
Immediately reversible
Safe in breast feeding
Can be inserted immediately PP or at 6 weeks
Cost effective and covered by most insurance companies

40
Q

How long is the postgesterone IUD effective? What is the method that is used to prevent pregnancy?

A

3-7 years

Prevents ovulation and blocks sperm from entering the cervix by causing the cervical mucus to be very thick

41
Q

What are the brands of the progesterone IUD? What are the SE?

A

Mirena, Kyleena, liltta, skyla

Amenorrhea and irregular spotting/bleeding

42
Q

What does the copper IUD do to prevent pregnancy? How long is it effective for?

A

Inflammatory rx that is toxic to sperm and ovum which prevents fertilization and prevents implantation

Protection for up to 12 years

43
Q

What are the SE of a copper IUD?

A

bleeding between periods, heavy menses, cramps, severe menstrual pain

44
Q

What is the failure rate for nexplanon? When can it be given? Safe in breastfeeding?

A

Less than 0.5% failure rate with typical use

Can be given immediately PP or 6 weeks

Yes safe in breast feeding

45
Q

How long is nexplanon effective for? SE? What is it do? When is it placed?

A

Progesterone containing rid placed in the inner upper arm

Slow released of progesterone

Effective for 4 years

SE: irregular bleeding/spotting

46
Q

What is the failure rate vasectomy? What occurs during this procedure?

A

0.5% failure rate

Removal of part of the vas deferens  prevents sperm from leaving body

47
Q

What needs to be check after a vasectomy?

A

Need to do a sperm check d/t fertile for up to 3 months and another method should be used until no sperm noted via sperm count

48
Q

What is the failure rate of tube litigation? What occurs this procedure?

A

0.5% failure

Requires abdominal incision
Suture tied around segment of tube with removal/cauterization of the ends

49
Q

When is tube litigation done? What are the risks?

A

Done 24-48 hours after vaginal birth, during c-section or at 6 weeks PP

Increased risk of ectopic pregnancy becomes pregnancy

50
Q

What is the failure rate of salpingectomy? What is done in the procedure? When is it done? Risks?

A

Almost 0% failure rate
Complete removal of fallopian tube
Requires abdominal incision and can be done within 24-48 hours after vaginal delivery and during c-section
Less risk of ectopic pregnancy
CANNOT be reversed

51
Q

What are the benefits of tube litigation or removal? What do these require?

A

Reduction in ovarian CA with tubal removal/ligation

Tubal ligation/tubal removal needs informed consent and counseling before labor if going to be done during hospitalization

52
Q

What is ensure? What does this include? What are the complications?

A

Voluntarily taken off market in dec 2018
Metal coils placed in fallopian tubes using a hysteroscope inserted through cervix  scarring to block tubes
Done in clinic
Complications include perforations and migration, long term pelvic pain, ectopic pregnancy, menstrual changes

53
Q

What are the permanent method? Are the safe in breastfeeding? Can they be reversed?

A

Tubal ligation
Tubal removal
Male sterilization
Essure

Yes safe in breastfeeding

possibility of reversal but not covered by insurance and doesn’t always work

54
Q

What is the nurses role conception in PP period?

A

Nurses have the potential to educate women and their families about these issues and promote behaviors that can minimize risks
Thorough understanding of PP sexuality and contraception options are necessary for nurses who plan to work with childbearing families
Providing women with education and a means to control their fertility are important steps in addressing both of these issues
Set aside personal views on contraception, be aware of the issues, and work to improve health outcomes.

55
Q

What is a valmentous insertion? What can it cause?

A

The vessels of the cord divide some distance from the placenta in the membranes – bare vessels run through the membranes unprotected by wartons jelly

Can cause hemorrhage if vessel is torn during ROM

56
Q

What is vasa previa? What is the risk?

A

Velamentous insertion with the unprotected fetal vessels present at/lying over the cervical os

Rupture with SROM or when AROM –> severe bleeding and high fetal mortality rate

57
Q

What is succenturiate placenta? What is the risk?

A

Placenta has one or more accessory lobes

Risk for postpartum hemorrhage if extra lobe is not delivered and remains in uterus

58
Q

What is battledore placenta? What is the risk?

A

The cord is inserted at or near the margin (at the edge) and raised/firm ridge around the placenta

Increased incidence of preterm bleeding and labor

59
Q

What is placenta accreta?

A

The placenta implants too deeply into the uterine wall and attaches to the myometrium

60
Q

What is placenta increta?

A

The placenta invades into the myometrium

61
Q

What is placenta percreta?

A

The placenta invades through the myometrium and may attach to outside organs (most commonly, the bladder)

62
Q

What puts patients at an increased risk for placenta implantation problems?

A

More common if previously had a c-section. Each c-section increases the risk

63
Q

Will you know about implantation problems before delivery? If start to PPH what could be possible treatment with placental implantation issues?

A

May not always know before delivery so begin to have PPH

Can have to have a hysterectomy because cant get all of the placental tissue out without destroy the uterine wall

64
Q

What is anhydramnios? What is cause? Treatment?

A

No fluid

Causes and treatment similar to oligohydramnios

65
Q

What is the treatment for PROM?

A

Induction of labor in 12-24 hours to reduce incidence of infection

85% will go into labor spontaneously within 24 hours

May depend on GBS status (if positive give antibiotics, wait 4 hours and then begin induction of labor)

66
Q

What is the treatment for PPROM?

A

Depends on gestational age and whether of not infection is present
Assessment/treatment
Amniocentesis to r/o infection
Antibiotics
Corticosteroids for lung maturity and decrease risk of resp. distress syndrome
Fetal assessment/surveillance with EFM and US
Major source of perinatal deaths (18-20%)

67
Q

What is the main cause for PPROM? Do you always give antibiotics?

A

Often caused by an infection

Antibiotics given whether there is an infection or not and it will help to delay delivery until we can give corticosteroids

68
Q

What would you evaluate for an infection in mom? In fetus?

A

Maternal fever
WBC
Pulse
Amniotic fluid - Clear? Odor? Meconium?

Baseline heart rate
Tachycardia – comes before maternal fever
Variability
Decelerations

69
Q

What is oligohydramnios?

A

Less than normal amount of amniotic fluid (>500ml is normal)
Amniotic fluid index (AFI) less than 5cm

70
Q

What are the causes of oligohydramnios?

A

Unknown
Post-maturity (more than 42 weeks b/c placenta begins to deteriorate  not oxygenating as well –> shunting blood away from kidneys to vital)
Renal malformations (renal agenesis - lack of normal renal tissue so can produce urine)
IUGR - sign of not getting enough perfusion
Placental insufficiency

71
Q

What usually goes hand in hand with oligohydramnios?

A

IUGR

72
Q

How does oligohydramnios affect the first part of pregnancy?

A

Fetal adhesions (amniotic bands) -chorion or amnion can adhere to fetus and cause amputations
Skeletal abnormalities – fetus doesn’t have room to more
Skin abnormalities
Pulmonary hypoplasia – lungs can’t develop b/c fluid keeps lung tissue open and develop muscle in chest

73
Q

How does oligohydramnios affect labor?

A

More fetal variable decelerations d/t cord compression

74
Q

What is the oligohydramnios treatment? Why is this used?

A

Amnioinfusion - Sterile, normal saline, or LR solution introduced through the intrauterine pressure catheter (IUPC) into the uterus

Used to treat variable decelerations - replaces amniotic fluid around fetus

75
Q

What is the amnioinfusion protocol? What should you monitor for during this procedure?

A

Many protocols for infusion:
500 ml bolus x 1
250 ml bolus, then 75 ml/hr

Monitor what is going in and what is leaking out onto the chux

76
Q

When is an amnioinfusion not used as treatment for oligohydramnios?

A

If the patient is not in labor and is pre-term

77
Q

What is hydramnios?

A

Greater than 2000 ml of amniotic fluid
AFI > 20 - 24

78
Q

What are the causes of hydramnios?

A

Neurologic abnormalities
Renal abnormalities
DM – high glucose more pee
Infections (herpes, rubella)
Acute or chronic
Idiopathic

79
Q

Why are neurologic abnormalities the most common cause of hydramnios?

A

if fetus can’t swallow then the fetus will continue to pee but it is not recycling the fluid that is already in the sac, instead just leads to more pee without recycling

80
Q

What occurs with ROM when there is hyramnios?

A

There is a huge pressure change which leads to a high risk of cord prolapse

81
Q

What are the fetal risks for hydramnios? What are the maternal risks for hydramnios?

A

Fetal: malpresentation, prolapsed cord

Maternal: resp distress (pressure on diaphragm)

82
Q

What is the treatment for hydramnios?

A

Removal of excessive fluid by amniocentesis – most of time fluid will come back
AROM by “needle” amniotomy with a “double” set-up in labor
Indomethacin PO to mother to decreases fetal urine output

83
Q

How is AROM by needle done r/t hydramnios?

A

done very slowly to avoid the huge pressure change to decrease the risk of cord prolapse

84
Q

What is a prolapsed umbilical cord? What occurs with this?

A

The umbilical cord precedes the fetal presenting part

Gets trapped between the presenting part and the maternal pelvis

Blood vessels compressed

85
Q

What are the two types of prolapse umbilical cord?

A

Overt - Visible in/outside the vaginal introitus
Occult - Cord lies just ahead or along the presenting part

86
Q

What are the maternal risks for a prolapsed card? Fetal risks?

A

Maternal: No direct risk

Fetus: FHR changes: prolonger decelerations/persistent bradycardia
May lead to death

87
Q

What is the management of prolapsed cord?

A

EMERGENCY
Prevent - no AROM if head is not engaged
Relieve pressure
Maternal positioning of trendelenberg or knee/chest
Remove baby from uterus with a c-section

88
Q

How do you relieve pressure on the cord with a prolapsed cord?

A

Push the presenting part off of the cord via vaginal exam

Ride the bed with the patient to the OR – do not remove fingers!

89
Q

Are cord accidents common? What is the chance of death from these accidents? What are the two types of accidents?

A

Cord Issues are common: ~25-35% of births

Less than 0.4% of the babies with these issues will die from them

Nuchal cord and true knot

90
Q

What is nuchal cord? How will this change delivery? What can it cause?

A

Cord around the neck

May have to cut the cord and unwrap it before the rest of baby body is born or you can try to loosen it up.

Causes variable decelerations with contractions because as the uterus contracts, the cord gets tight and cord compression

91
Q

What is true knot? What is the risk with this?

A

Cord gets tied into a knot

If knot gets tighten then fetus wont get any oxygen and cause fetal demise

OB (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions