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OB > Test 2 Blueprint (2) > Flashcards

Test 2 Blueprint (2) Flashcards

1
Q

Beginning of one contraction to the beginning of the next contraction.

A

Frequency

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2
Q

Beginning to end of one contraction.

A

Duration

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3
Q

Frequency is measured in ____.

Duration is measured in ____.

A

minutes

seconds

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4
Q

How strong the contraction FEELS upon palpation.

A

Intensity

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5
Q

Intensity is classified as:

A

mild (nose)
moderate (chin)
strong (forehead)

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6
Q

The period in between contractions; palpation of uterus when no contraction is taking place.

A

Resting tone

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7
Q

Interventions for Late or Variable decels:

The Big 5

A

1) Reposition pt…prop on side
2) O2 per facemask
3) IV fluids or fluid bolus
4) Stop oxytocin
5) Call the doctor

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8
Q

What level of O2 is generally ordered?

A

8 to 10 L/min

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9
Q

Accelerations are indicative of ____ ____ ____ and ____ ____ which are considered signs of fetal well being.

A

well oxygenated fetus

fetal movement

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10
Q

What is an amniotomy?

A

AROM

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11
Q

Why is an amniotomy performed?

A

Induce or augment labor

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12
Q

The longer the membranes are ruptured, the greater the risk for ____.

A

infection

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13
Q

How often is temp measured after ROM?

A

q 1-2 hr

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14
Q

If membranes are ruptured more than 24, what intervention is performed?

A

prophylactic antibiotics as ordered

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15
Q

What would you assess immediately following ROM?

A

Amniotic fluid: color & odor

FHT: decels or change in variability

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16
Q

If variable decels are noted, check for ____ ____.

A

cord prolapse

This is an emergency!

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17
Q

Normal amniotic fluid…

A

Pale/straw colored
Flecks of vernix caseosa, lanugo, scalp hair
Characteristic odor

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18
Q

Abnormal amniotic fluid…

Greenish brown color

A

Meconium in fluid

Risk for fetal meconium aspiration

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19
Q

Abnormal amniotic fluid…

Yellow color

A
  • Infection
  • Breech presentation r/t pressure on fetal abdominal wall during decent
    (May also be rupture of gonorrhea/chlamydia lesions)
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20
Q

Abnormal amniotic fluid…

Port wine color

A

Bleeding, possible abruption, premature separation of placenta

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21
Q

Abnormal amniotic fluid…

Thick, cloudy, foul odor

A

Intrauterine infection

22
Q

What 5 things are assessed in the APGAR score?

A 
Appearance (color)
Pulse (HR)
Grimace (Reflex irritability)
Activity (Muscle tone)
Respirations
23
Q

When is APGAR score performed? What is considered normal?

A

1 and 5 min immediately after delivery

7-10 score normal

24
Q

APGAR…

Appearance (Color)

A

0 blue, pale
1 acrocyanosis
2 completely pink

25
Q

APGAR…

Pulse (HR)

A

0 absent

1 100

26
Q

APGAR…

Grimace (Reflex irritability)

A

0 none
1 grimace
2 cry

27
Q

APGAR…

Activity (Muscle tone)

A

0 flaccid
1 some flexion
2 well-flexed

28
Q

APGAR…

Respirations

A

0 absent
1 slow, weak cry
2 good cry

29
Q

Why is oxytocin important after delivery?

A

promotes uterine contractions

vasoconstriction

30
Q

Why don’t we want contractions any closer than 2 min apart?

A

Insufficient time to reoxygenate fetus between contractions

31
Q

What happens if mother is hypotensive?

A

not enough pressure to adequately reperfuse placenta

32
Q

When do you give Stadol (butorphanol tartrate)?

A

At the top of the contraction; due to vasoconstriction during contraction, the fetus will get less and the mom will get more

33
Q

What is the goal of pain relief?

A

adequate pain relief without increasing maternal or fetal risk
OR affecting the progress of labor

34
Q

Is it ok to give a preganant/laboring woman BENZODIAZEPINES?

A

No, this will effect the baby’s ability to thermoregulate

35
Q

What is the #1 stressor to a newborn?

A

cold

36
Q

What are 2 examples of barbiturates?

A

Seconal (secobarbital) **this is no longer given

Nembutal (pentobarbital)

37
Q

Can barbiturates be given during active labor? Why or why not?

A

NO

Causes CNS depression of newborn

38
Q

Name 2 ataractics:

A

Reglan (metoclopramide)

Phenergan (promethazine)

39
Q

What effect do ataractics have on the fetus?

A

CNS depression

40
Q

Can ataractics be given with benzos?

A

No

41
Q

Name 4 examples of opioids?

A

Dilaudid (hydromorphone)
Demerol (meperidine)
Sublimaze (fentanyl)
Sufenta (sufentanil)

42
Q

What effect does Demerol (meperidine) have on the newborn?

A

Causes prolonged neurobehavioral changes that can last for 2-3 days

43
Q

Sufenta (sufentanil) does not cross the ____ as readily so ____ fetal exposure.

A

placenta

less

44
Q

What is an antidote for opioid overdose?

A

Narcan (naloxone hcl)

45
Q

Can Narcan (naloxone hcl) reverse Stadol or Nubain?

A

No, these are opioid agonist-antagonists

46
Q

List 2 opioid agonist-antagonists:

A

Stadol (butorphanol tartrate)

Nubain (nalbuphine hcl)

47
Q

What is a positive characteristic of opioid agonist-antagonists like Stadol and Nubain?

A

Adequate analgesia w/o resp depression in mom or baby

48
Q

What is a negative characteristic of opioid agonist-antagonists like Stadol or Nubain?

A

May precipitate withdrawal symptoms in narcotic dependent women and babies

49
Q

What interventions can be performed in an infant with resp depression to get opioid out of system faster?

A

stimulation (rub vigorously with towel)

fluids

50
Q

What is negative about a spinal block?

A

Increased incidence and degree of hypotension

51
Q

Negative of general anesthesia?

A

fetal resp depression, hypotonia, lethargy

OB (12 decks)

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