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NURS: 2146 OB > Test 2 C/S > Flashcards

Test 2 C/S Flashcards

1
Q

1 Reason

Reasons for C/S

A

Labor arrest Dilation Stops
Nonreassuring fetal tracing Cat 2 or 3
Malpresentation Breech, Transverse, Occoput posistion
Multiple gestation
Maternal/fetal reasons
Preeclampsia
Maternal request

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2
Q

C/S Increased Risk

Maternal/ Infant

A

Infection 5 - 20x
Hemorrhage
Urinary tract trauma
Paralytic ileus
Anesthesia (aspiration)

Infant

Transient Tachypnea
Laceration / Trauma

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3
Q

It is recommended that mothers wait at home until True Labor begins then go to the hospital

T or F

A

T

This will prevent C sections
Walking helps the most

Regular, strong contractions that are occurring every 5 minutes or less, lasting for at least a minute each, for a period of at least an hour, or if her water breaks, regardless of contraction strength

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4
Q

Before giving Pitocin what should the uterus state be…

A

Ripe

Thinned out

Give misoprostol to ripe the cervix

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5
Q

What would be a good candidate for TOLAC/VBAC

A

When the last birth was theyes babies fault they couldn’t be born vaginal.

Breech baby / Issues with fetal heart tones

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6
Q

Decrease C section rate most in which type

A

Nulliparous women with a term, Singleton baby in vertex posistion delivered without C Section

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7
Q

Transient respiratory morbidity is higher in CS than VB why?

A

Fluid in lungs

Vag birth squeezes the fluid out of the lungs

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8
Q

CS Urgency Time frame

Scheduled

Unscheduled Add-On

Urgent

STAT

A

Scheduled: Planned preassigned date

Unscheduled Add-On: Non emergency Wait until patient is 6Hrs NPO

Urgent: Decesion to incision time <30 min

STAT: Deceaion to incision <10 min

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9
Q

Home CS prep the night before

A

NPO Past midnight

Reg meds (sip water)

Diabetic meds esp important (Insulin drip in OR)

NO SHAVING WITH REG RWZOR

SHOWER night before

Hibiclens (Chlorhexidine)

Remove all metal (rings ect)

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10
Q

Prep OP CS Orders

A

CBC T&S

IV 18 G

INTRADERMAL Lidocaine PRN for IV start

LR 125 cc / hr

500cc Bolus prior to spinal anesthesia

Antibiotic 1 - 2 G Cephalexin
<80KG = 1G / >80Kg = 2G

Bicitra (Sodium citrate) Neutralize Stomach Acid & Nausea. Taste Sour

So not to aspirate Acid contents

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11
Q

SCDs during C/S

Foley?

What does the ElectroCautery ground pad do? LOCATION?

A

Yes

Yes

Purpose: Prevents electrical burns by dispersing the current over a larger surface area as it exits the body.

Placement: thigh or buttock good skin contact, far from bony prominences, metal implants, and the surgical site

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12
Q

Difference between a Spinal & Epidural

A

Spinal injects all meds at once

Epidural stays in and continue to infuse

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13
Q

If woman is in labor for 24 hours which procedure is added to the C/S

This procedure wouldn’t be done if it was a scheduled CS

A

Betadine perineal area

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14
Q

Chlorohexiden wipe on abdominal area will be tinted orange. Explan to mom why orange

A

Ok

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15
Q

Lower Transverse Cesarean are the typical

Why would a classical be used?

A

Past vertical scar from surgery and surgeon wants to use the same entry

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16
Q

CS layers (7)

A

Studying all Friday may provide us A’s

Skin
Adipose
Fascia - possible adhesions if R C/S
Muscle
Peritoneum
Uterus
Amniotic sac- May feel pressure / tugging when baby born. No pain

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17
Q

_____ is used to protect the ballder from the scalple.

A

Bladder blade

This will happen right before uterine incision before baby is pull3d out

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18
Q

Circulating RN responsibility

A

4 counts: Instruments, Sponges, Needles

Documention: Team members, Times, Delivery/baby information

Calculate QBL

Ensure sterile field

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19
Q

Is oxytocin continued in the PACU?

A

Yes

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20
Q

If PCA or Duramorph - morphine-like (Intrathecal route -Spine) monitor for…

A

Respiratory depression/ effectiveness of pain control

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21
Q

What are priority assessment in the PACU 2 HRS postop

A

Fundal height/ Lochia

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22
Q

______ involves holding a pillow, blanket, or specially designed splinting device firmly against the surgical site when coughing, sneezing, or moving.

A

Splinting

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23
Q

Most effective birth control method

A

Implantation 0.05 failure rate

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24
Q

Top 5 most effective birth control methods

A

Implantation 0.05
IUD 0.2 - 0.8
Sterilization 0.15 - 0.5
Injection 6
Pill 9

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25
Q

Failure rate of condom

A

18%

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26
Q

Fetal Hypoxemia causes

Brady / Tachycardia

A

Tachycardia

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27
Q

Accelerations have this time to reach their peak amount

A

<30 seconds

Abrupt

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28
Q

Cephopelvic disproportion happens with which deceleration…

A

Early 😀

29
Q

How often is mom having contractions

Is called….

Is measured how? What units?

CORRECT

A

UC frequency

Range (From beginning of one contraction to beginning of next)

Minutes

EX 2 - 3 minutes

30
Q

How long do the contractions last?

Is called…

How to measure? Which units?

A

Duration

Range (From beginning to end)

Seconds

EX 50 - 100 Seconds

31
Q

How long must contraction be to be considered a contraction

A

Atleast 40 seconds

32
Q

Describe ideal uterus resting tone between contractions

A

Soft & non tender

33
Q

BMI
<18.5
18.5 - 24.9
25 - 29.9
>30

Total preggers weight gain?
Weekly 2nd & 3rd trimester

A

<18.5 ( 28 - 40)
18.5 - 24.9 (25 - 35)
25 - 29.9 (15 - 25)
>30 (11 - 20)

<18.5 (1lb week)
18.5 - 24.9 (1lb week)
25 - 29.9 (0.5 lb week)
>30 (0.5 lb week)

34
Q

Fre

A
35
Q

A rise of ____ % in hCG over 48 hours can be considered normal

A

35%

36
Q

Pregnancy

Presumptive symptoms
Probable symptoms
Positive

A

Presumptive symptoms
Fatigue
N/V
Urinary frequency
Amenorrhea
Breast changes

Probable symptoms

Chadwick sign: Bluish vag, cervix, vulva
Goodell sign: softening vag portion of cervix from Vascularization

Hegar sign: Softening of cervical isthmus (Cervical portion between uterus & vag)

POSITIVE Hcg TEST

Positive: IUP Intrauterine pregnancy on US, Fetal heart tones / movements

37
Q

Diastasis recti….

A

Separation of the rectus abdominal abs

38
Q

Match these words to the appropriate trimester

Identify with the mother role
Prepares for birth
Ambivalent

A

Ambivalent 1st
Identify with the mother role 2nd
Prepares for birth 3rd

39
Q

Which week does a primitive heart beat start

A

3rd

40
Q

All major organ systems formed Most vulnerable to Teratogens

A

3 - 8

41
Q

Heart begins to pump
Arms and legs bud
Facial features beginning to form

Weeks….

A

5 - 8

42
Q

Extremities developed
External Genital differentiated

Weeks

A

9 - 12

43
Q

Fetus begins to move
Urine begins to form

Weeks….

A

13 - 16

44
Q

Meconium begins to collect in bowel

Weeks

A

17 - 20

45
Q

Skin wrinkled, red, vernix, lanugo

Lungs begin to dev surfactant

Weeks

A

21 - 24

46
Q

Eyes partially opened
Respiratory system still imature

Weeks

A

25 - 28

47
Q

Toe nails present
Testies descended

Weeks

A

29 - 32

48
Q

Skin thicker, less wrinkled
Subcutaneous fat accumulation
Excelente chance for survival

A

33 - 36

49
Q

Baby gains fat
Nails extend beyond nail bed

Weeks

A

37 - 40

50
Q

AFI range indicative of fetal well being

A

8 - 20

51
Q

Which fetal cord structure carries blood woth the most O²

A

Umbilical vein

52
Q

Connects the pulmonary artery & descending aorta

A

Ductus Arteriosus

53
Q

Which shunt closes first

A

Foramen Ovale (minutes)

54
Q

Which shunt causes a Murmur to be heard.

When does it close

A

Ductus Arteriosus

Gradually 15 - 24 hrs

55
Q

Routine & Non routine
1st prenatal visit
1st trimester screening

Correct

A

1st prenatal visit

Pregnancy test
Blood/urine test
Dating ultrasound

1st trimester screening
Maternal blood serum: Checking for chromosomal abnormalities (Downs)

Nuchal Translucency Test: This is an ultrasound that measures the clear space at the back of the fetal neck. Increased thickness in this nuchal translucency can be associated with a higher risk of chromosomal abnormalities, like Down syndrome, as well as congenital heart defects.

Non - Routine

Cell free DNA: Screening Test checks maternal blood for Chromosomal abnormalities

Chorionic Villus Sampling: Diagnostic
Small piece of the placenta is removed and cells analyzed to diagnose chromosomal abnormalities

56
Q

VDRL , RPR
Test for…

A

Syphilis

57
Q

Taking OTC vitamins is the best practice for baby health

T or F

A

F

Only take prescribed vitamins

58
Q

Reflexes disappear in this order give dates

Rooting
Moro
Palmar / Plantar
Babinski
Sucking

A

Rooting 3 - 4 months
Moro 5 - 6 months
Palmar / Plantar 2 -3 & 8 -9 months
Babinski 8- 9 months
Sucking 12 months

59
Q

Abnormal reasons why no reflexes

Rooting
Moro
Palmar/Plantar
Babinski
Sucking

A

Rooting: Premature, neurological, drugs

Moro: Absent CNS dysfunction

Palmar/Plantar: Neurological defects

Babinski: bilateral CNS / Unilateral Nerve damage

Sucking: Premature, neurological, drugs

60
Q

Age infant to sit with support?

Age to sit by themselves?

A

6 - 8

8 - 12

61
Q

Which age for object permence

A

8 - 12 months

62
Q

____ is given to preggers mom in the 3rd trimester to prevent whooping cough

A

Dtap vaccine

63
Q

Pregnancy related mortality ratio

Which groups are most likely to die

A

Black
Indians
White
Asians
Latinos

64
Q

____ % of PRMR can be prevented

A

60%

65
Q

Which ethic considerations is most important

A

Nonmalifence

66
Q

_______ is the principle that all people are of equal moral worth and deserve equal rights, opportunities, and resources.

A

Egalitarianism

67
Q

Placental Placement and considerations

Anterior

Posterior

Previa

Low laying

A

Anterior: Feels less kicks and harder to measure heart rate

Posterior: Desired, easier to feel movements and measure HR

Previa: avoid strenuous task / Bedtime rest / C/S maybe needed if during 3rd

Low laying: Low but not covering cervix. Will move up as uterus expands

68
Q

Does the morning after pill affect a 1 month old fetus?

A

No, only stops implantation

NURS: 2146 OB (16 decks)

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