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OB > Test 2 Blueprint (3) > Flashcards

Test 2 Blueprint (3) Flashcards

1
Q

2 reasons the laboring woman must keep her bladder empty:

A

1) distended bladder may impede descent of baby

2) bladder trauma, leads to decreased bladder tone/uterine atony after birth

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2
Q

How often should a laboring woman void?

A

q1-2hr

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3
Q

Why are women given an IV bolus before an epidural?

A

Increases vascular space
Decreases fetal compromise
Keeps mom from becoming hypotensive

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4
Q

Mom needs to wear ____ ____ after epidural.

A

pulse oximeter

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5
Q

What is considered hypotensive for mom?

A

systolic below 100

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6
Q

If mom’s HR drops, baby’s HR ____.

A

drops

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7
Q

What interventions should be done if mom becomes hypotensive?

A

1) Prop mom on side
2) Increase fluids
3) Admin O2
4) Elevate legs 10-20 degrees
5) Call MD
6) Would need ephedrine (vasoconstrictor)

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8
Q

After an epidural, vitals should be taken:

A

every 5 min for first 20 min

then every 30 min

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9
Q

Relation of baby’s spine to mom’s spine:

A

Fetal lie

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10
Q

Transverse means baby’s spine is at ____ ____ to mom’s spine.

A

right angle

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11
Q

Longitudinal or vertical lie means baby’s spine is ____ to mom’s spine.

A

parallel

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12
Q

T/F: Presenting part is the part of the baby that comes out of the vagina first.

A

True

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13
Q

Relation of fetal parts to one another:

A

Attitude

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14
Q

Head flexed, arms folded, legs onto abdomen, back curved in shape of C. Examiner palpates POSTERIOR fontanel.

A

General flexion

AKA: fetal position

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15
Q

Presents wider part of skull to inlet. Examiner palpates the mentum (chin) or brow.

A

Extended

dangerous position

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16
Q

Why is EXTENDED ATTITUDE bad for baby?

A

Can break baby’s neck

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17
Q

Presentation of baby in relation to front, back, or side of maternal pelvis:

A

Position

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18
Q

1st letter
2nd letter
3rd letter

A

1st letter: R or L of maternal pelvis
2nd letter: specific presenting part of fetus
3rd letter: location of the presenting part in relation to maternal pelvis

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19
Q

Labels for presenting part of fetus (2nd letter)

A

O=occiput
M=mentum (chin)
S=sacrum
A=acromion process (scapula)

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20
Q

Labels for presenting part in relation to maternal pelvis (3rd letter)

A

A=anterior (symphysis pubis)
P=posterior (sacrum)
T=transverse (to mom’s side)

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21
Q

Which presentation is best for vaginal delivery?

A

Cephalic

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22
Q

Which fetal position is easiest for vaginal delivery?

A

LOA

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23
Q

Biparietal diameter:

A

measurement of head at widest part to evaluate if it will fit through birth canal

24
Q

What positions are labeled as “breech”?

A

sacrum
foot
shoulder

25
Q

These must be C-section:

A

Mentum (M is the middle letter)
Shoulder
Transverse (T is the last letter)

26
Q

What constitutes fetal tachycardia?

A

FHR > than 160 bpm

Lasts more than 10 min

27
Q

What causes fetal tachycardia?

A 
Early fetal hypoxemia
Maternal fever
Maternal dehydration
Drug induced
Intraamniotic infection
Maternal hypothyroidism
Fetal anemia
Fetal heart failure
Fetal cardiac dysrhythmia
28
Q

What drugs can cause fetal tachycardia?

A

atropine
ritodrine
cocaine
methamphetamine

29
Q

What is fetal bradycardia?

A

FHR

30
Q

What causes fetal bradycardia?

A 
Late fetal hypoxemia
Hypoxia
Drug induced
Maternal hypotension/hypertension
Prolonged umbilical cord compression
Fetal congenital heart block
Maternal hypothermia
Prolonged maternal hypoglycemia
Last sign of hypoxia
31
Q

What drugs can cause fetal bradycardia?

A 
MgSO4
Propanolol
Anesthetics
Epidural
Stadol
32
Q

What 2 things must happen before applying an IUPC or ISE?

A

ROM

Cervix dilated

33
Q

TN nurses (can/cannot) place IUPC or ISE? What about MS nurses?

A

TN can

MS cannot

34
Q

When assessing fetal heartrate, what is PMI?

A

location on maternal abdomen at which the FHR is heard the loudest

35
Q

What part of the fetus is the HR usually heard best?

A

Over the the fetus’ back

36
Q

Where would you find FHT if baby is cephalic? (cephalic = below umilicus)

A

BELOW the mother’s umbilicus

Either the RLQ or LLQ of mom’s abdomen (over baby’s back)

37
Q

Where would you find FHT if baby is breech? (breech = above umbilicus)

A

ABOVE the mother’s umbilicus

38
Q

What shape pelvis is best for vaginal delivery?

A

gynecoid

39
Q

In 4th stage of labor, what things are checked?

A 
Vitals
Activity (can feel legs or wiggle toes)
LOC
Color of mom
Fundus
Lochia
Perineum
40
Q

When assessing mom’s color after delivery, what should be done if pallor is seen?

A

Ask MD to order Hct to see if too much blood was lost during delivery

41
Q

In 4th stage of labor, what should be seen with the fundus?

A
  • firm
  • midline
  • halfway between umbilicus and symphysis pubis
42
Q

After delivery, lochia should be:

A

rubra, no large clots…small ok

43
Q

After delivery, perineum should be assessed by _____.

A 
REEDA
Redness
Edema
Ecchymosis
Drainage
Approximation (suture line straight or gaps/bulges?)
44
Q

Intervention for boggy uterus/fundus?

A 
Assess bladder - may be distended (void)
Breastfeed - releases oxytocin
Nipple stimulation - releases oxytocin
Uterine massage - promotes vasoconstriction
Admin oxytocin
45
Q

Intervention for fundus deviated to right of umbilicus?

A
  • Assess bladder - distended bladder may push uterus off center
  • Void
  • Reassess fundus
46
Q

True labor results in ___ ___.

A

cervical change

47
Q

7 signs of true labor:

A

1) Regular contraction
2) Start in back
3) Contractions increase in intensity and duration
4) Walking intensifies contractions
5) Mucus plug discharged
6) Cervix dilated
7) Sedation doesn’t stop contractions

48
Q

Multipara:

A

completed 2 or more pregnancies to 20 wks or more gestation

49
Q

Nullipara:

A

not completed a pregnancy with a fetus or fetuses beyond 20 wks gestation

50
Q

The enlargement of widening of the cervical opening and the cervical canal that occurs once labor has begun:

A

Dilation

51
Q

The shortening and thinning of the cervix during the first stage of labor. Generally progresses significantly in first-time term pregnancy before more than slight dilation occurs. In subsequent pregnancies, this and dilation of the cervix tend to progress together.

A

Effacement

52
Q

Dilation is expressed in:

A

0 to 10 cm

53
Q

Effacement is expressed in:

A

0 to 100%

54
Q

Relationship of the presenting fetal part to an imaginary line drawn between the ischial spines of the pelvis. It is a measure of the degree of descent of the presenting part of the fetus through the birth canal.

A

Station

55
Q

Signs and symptoms of uterine infection:

A
  • pain in lower abdomen
  • fever
  • foul-smelling vaginal discharge
  • rapid HR
  • swollen and tender uterus
56
Q

What things can introduce or make uterus susceptible to bacteria?

A
  • ruptured membranes (esp 18-24 hrs later)
  • vaginal exams (sterile gloves should be used)
  • mucus plug is expelled
  • anemia
  • prolonged labor

OB (12 decks)

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