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NUR 239 > Test #7: OB > Flashcards

Test #7: OB Flashcards

1
Q

What is the largest cause of spontaneous abortion?

A

Congenital problems of the baby

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2
Q

What is a “spontaneous abortion”?

A

The medical term for miscarriage

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3
Q

What is a “threatened abortion”?

A

Bleeding in the first half of pregnancy

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4
Q

Post-miscarriage, what will contents left in the uterus cause?

A

Bleeding and infection

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5
Q

What is a “missed abortion”?

A

Where the mother is unaware that the baby died

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6
Q

What is the only “absolute” sign of pregnancy?

A

Fetal Heart Rate

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7
Q

What should a patient, post-miscarriage be taught?

A

No tampon use or sex until being cleared by the doctor

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8
Q

After a missed-abortion, what will contents left in the uterus cause?

A

Bleeding (DIC) and infection

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9
Q

What is a risk factor for ectopic pregnancy?

A

Pelvic infection or pelvic inflammatory disease

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10
Q

What is the most sensitive test to determine fibrin levels (used in patients with DIC)?

A

D-dimer

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11
Q

How long should a woman who had a molar-pregnancy be monitored for choriocarcinoma?

A

For 1 year

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12
Q

How is a molar pregnancy treated?

A

Vacuum aspiration is used to extract the mole; then IV oxytocin is used to contract the uterus

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13
Q

What is it important not to stimulate uterine contractions before the uterus is evacuated? (in molar pregnancy)

A

Because contractions can cause trophoblastic tissue to be drawn into venous circulation, resulting in embolization of the vesicles

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14
Q

What is the “classic sign” of placenta previa?

A

Painless uterine bleeding in the second half of pregnancy

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15
Q

What assessment should not be done on a patient with placenta previa?

A

Digital examination of the cervical os (can cause serious bleeding)

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16
Q

What 4 things should a patient be taught to monitor for management of placenta previa at home?

A
  1. Assess discharge or bleeding
  2. Count fetal movement
  3. Assess uterine activity (contractions) daily
  4. No sex (to prevent displacement of the placenta)
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17
Q

Why is a pregnant woman positioned on her left side?

A

Because lying flat on her back can cause vena cava compression; side-lying promotes placenta perfusion

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18
Q

What is the main symptom of a concealed abruptio placenta?

A

Rigid, board-like abdomen

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19
Q

What is the primary risk factor for abruptio placenta?

A

Maternal cocain use

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20
Q

What test cannot be used to diagnose abruptio placenta?

A

Ultrasound; because placental seperation and bleeding look similar on ultrasounds

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21
Q

What is the major danger for a woman with abruptio placenta?

A

Hemorrhage, DIC and/or hypovolemic shock

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22
Q

What test cannot be used to diagnose abruptio placenta?

A

Ultrasound; because placental separation and bleeding look similar on ultrasounds

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23
Q

What is “gestational hypertension”?

A

Blood pressure of >140/90 that develops after 20 weeks without proteinuria

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24
Q

What is “pre-eclampsia”?

A

A BP of >140/90 after 20 weeks with significant proteinuria

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25
Q

What is eclampsia?

A

Progression of preclampsia to seizures

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26
Q

What does epigastric pain in a patient with pre-eclampsia indicate?

A

It is a warning sign of decreased liver perfusion and often indicates that a seizure is imminent

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27
Q

What classification in Magnesium Sulfate?

A

A CNS depressant (tocolytic)

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28
Q

What is a warning sign of magnesium toxicity?

A

Respirations less than 12/min

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29
Q

What is the drug to treat magnesium toxicity?

A

Calcium gluconate

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30
Q

What is generally the first sign of eclampsia and/or impending maternal seizure?

A

Facial twitching

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31
Q

What is the advantage of Hydralazine over other antihypertensives?

A

In addition to vasodilation, it increases cardiac output and placental bloodflow.

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32
Q

What is the classic symptom of the HELLP syndrome?

A

Pain in the right upper quadrant, epigastrium or lower chest.

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33
Q

When does an Rh incompatibility occur?

A

When the Mom is Rh negative and the baby is Rh positive

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34
Q

What test is used to predict Rh incompatibility?

A

Coombs test

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35
Q

What complication might a diabetic mother have with amniotic fluid?

A

They may have an excess of amniotic fluid

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36
Q

What intervention is indicated for a prolapsed umbilical cord?

A

Immediate C-section

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37
Q

How much bleeding/lochia is considered “too much” after birth?

A

More than 1 pad per hour

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38
Q

How long should lochia be red?

A

First 3 days

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39
Q

How often should vital signs be checking in the post-partum patient?

A

Every 15 minutes until stable and then every hour

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40
Q

What contraction-inducing medication should not be given to a woman with hypertension?

A

Methergine

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41
Q

What contraction-inducing medication would be given if Pitocin is ineffective?

A

Prostin E2

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42
Q

Any time excessive bright red uterine bleeding is present and the fundus is contracted firmly at expected location, what is suspected as the cause?

A

lacerations of birth canal

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43
Q

What is subinvolution of the uterus?

A

where the uterus does not return to its normal size

44
Q

How fast does the uterus normally descend?

A

1 cm per day

45
Q

How often should a newborn be nursed?

A

Every 2-3 hours

46
Q

What is the technical definition of “preterm” or “premature” baby?

A

Less than 38 weeks

47
Q

What is the normal respiratory rate of a neonate/newborn?

A

30-60

48
Q

What respiratory rate is considered tachypnea in a neonate/newborn?

A

More than 60

49
Q

What 3 things point to infection in the postpartum woman?

A

fever >100.4 F, pelvic tenderness, or vaginal discharge with a foul odor

50
Q

What is the range of Proteinuria in mild preclampsia?

A

> 0.3 g but

51
Q

What is the range of Proteinuria in severe preclampsia?

A

> 5 g on 24 hour urine; 3+ or higher on dipstick

52
Q

What is the range of Proteinuria in severe preclampsia?

A

> 5 g on 24 hour urine; 3+ or higher on dipstick

53
Q

What is the therapeutic range of Magnesium?

A

4-8

54
Q

What is the antidote for Magnesium?

A

Calcium gluconate

55
Q

What is the antidote for Magnesium?

A

Calcium gluconate

56
Q

Why does the nurse have to be cautious when administering Magnesium and anti-hypertensives together to a woman in severe preclampsia?

A

Because signs of magnesium toxicity includes hypotension

57
Q

Why does the nurse have to be cautious when administering Magnesium and anti-hypertensives together to a woman in severe preclampsia?

A

Because signs of magnesium toxicity includes hypotension

58
Q

What does “HELLP” stand for?

A

Hemolysis
Elevated Liver enzymes
Low Platelet count

59
Q

What is the first sign of HELLP syndrome?

A

Pain in right upper quadrant, lower chest, or epigastric area

60
Q

What is the first sign of HELLP syndrome?

A

Pain in right upper quadrant, lower chest, or epigastric area

61
Q

What should the nurse keep in mind with administering Methyldopa to a pregnant patient with hypertension?

A

It may cause a positive Coombs test

62
Q

What should the nurse keep in mind with administering Methyldopa to a pregnant patient with hypertension?

A

It may cause a positive Coombs test

63
Q

What is the purpose of a Coombs test?

A

To detect detect maternal antibodies to Rh positive blood

64
Q

What is the purpose of a Coombs test?

A

To detect detect maternal antibodies to Rh positive blood

65
Q

When should RhoGam be administered?

A

At 28 weeks and within 72 hours of delivery

66
Q

When should RhoGam be administered?

A

At 28 weeks and within 72 hours of delivery

67
Q

When should RhoGam be administered?

A

At 28 weeks and within 72 hours of delivery

68
Q

What is Procardia (Nifedipine)?

A

A calcium channel blocker; used in pregnancy to relax smooth muscle (as a Tocolytic)

69
Q

In the event of premature birth, what intervention will decrease the risk/severity of hyperbilireubinemia?

A

Clamping the cord immediately rather than letting it pulsate

70
Q

What is the treatment for HELLP syndrome?

A

FFP, mag and hydralazine (and birth the baby)

71
Q

What is the treatment for HELLP syndrome?

A

FFP, mag and hydralazine (and birth the baby)

72
Q

What effects does gestational diabetes have on the baby?

A

Hypoglycemia, hypocalcemia and hyperbilireubinemia

73
Q

What effects does gestational diabetes have on the baby?

A

Hypoglycemia, hypocalcemia and hyperbilireubinemia

74
Q

How does an ectopic pregnancy often present?

A

Sudden, sharp, stabbing pain in the lower abdominal quadrant–referred pain the neck or shoulder

75
Q

Why is it important for Mom to void every 1-2 hours during labor?

A

Soft tissue obstruction; can keep labor from progressing

76
Q

Why is it important for Mom to void every 1-2 hours during labor?

A

Soft tissue obstruction; can keep labor from progressing

77
Q

What fetal heart rate is indicative of infection?

A

greater than 160

78
Q

What fetal heart rate is indicative of infection?

A

greater than 160

79
Q

In the event of premature rupture of membranes, what will the nitrazine paper show?

A

pH greater than 6.5, alkaline and paper will turn blue

80
Q

In the event of premature rupture of membranes, what will the nitrazine paper show?

A

pH greater than 6.5, alkaline and paper will turn blue

81
Q

When are corticosteriods used to mature the baby’s lungs?

A

Most effective given between 24 and 34 weeks gestation

82
Q

How long do corticosteroids need to take effect?

A

Birth must be halted for 24-48 hours for the drug to take effect

83
Q

How long do corticosteroids need to take effect?

A

Birth must be halted for 24-48 hours for the drug to take effect

84
Q

How long do corticosteroids need to take effect?

A

Birth must be halted for 24-48 hours for the drug to take effect

85
Q

What complication may be seen in a mother that goes over her due date?

A

Cord compression due to oligohydramnios, decreased placental function and meconium aspiration

86
Q

What complication may be seen in a mother that goes over her due at date?

A

Cord compression due to oligohydramnios, decreased placental function and meconium aspiration

87
Q

What is done to pt in prolonged labor?

A

if cervix is ripened (soft, dilate, and slight effacement) ten labor is induced. if not prostaglandin gel applied to the cervix

88
Q

What is a hypertonic contraction?

A

Longer than 90 seconds, less than 2 minutes between contractions or less than 30 seconds rest between contractions,

89
Q

What is a hypertonic contraction?

A

Longer than 90 seconds, less than 2 minutes between contractions or less than 30 seconds rest between contractions,

90
Q

manifestations of uterine atony after birth

A

fundus difficult to locate, uterus relaxes when massage stop, vaginal bleeding - pad every 15 is excessive

91
Q

management for uterine atony

A

regular fundal message, pitocin, metergine and hysterectomy for extreme atonia

92
Q

management for uterine atony

A

regular fundal message, pitocin, metergine and hysterectomy for extreme atonia

93
Q

management for uterine atony

A

regular fundal message, pitocin, metergine and hysterectomy for extreme atonia

94
Q

How long after birth until the uterus is not palpable anymore?

A

2 weeks

95
Q

What assessment finding indicates PKU?

A

musty urine

96
Q

what test detects PKU?

A

Guthrie blood test

97
Q

what typically results if PKU goes untreated?

A

mental retardation, musty body odor or urine, and seizures (trt includes low protein diet)

98
Q

What is Kernicterus?

A

it is the toxic accumulation of bilirubin in the brain and may cause severe brain damage.

99
Q

what is the most common cause of hyperbilirubinemia and kernicterus?

A

Rh and ABO inccompatibility

100
Q

what at some indications of a hopycalcemic newborn d/t diabetic mother

A

irritability, tremors, and high pitched cry

101
Q

the test used to screen for gestational diabetes is the?

A

oral glucose tolerance test

102
Q

a woman has shoulder dystocia when giving birth. the RN should expect which intervention

A

suprapublic pressure

103
Q

a mother has excess lochia 2 hours after delivering an 8lb baby, what should be the RN’s priority

A

assess the firmness of her uterus

104
Q

the best position for a women who has postpartum endometritis is?

A

Fowler’s

105
Q

what intervention would be expected in the first 8-12 hours after a post-term birth

A

blood glucose determination

NUR 239 (8 decks)

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